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利用横断面全国健康调查研究肥胖对在诊室内医生就诊时间和管理药物种类的影响。

The impact of obesity on time spent with the provider and number of medications managed during office-based physician visits using a cross-sectional, national health survey.

机构信息

Division of Adult and Communty Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

出版信息

BMC Public Health. 2009 Nov 30;9:436. doi: 10.1186/1471-2458-9-436.

Abstract

BACKGROUND

Obesity is associated with morbidity, mortality, and increased health care costs. Few studies have examined the impact of obesity on outpatient office visits. The purpose of this study was to determine if outpatient visits by obese persons required more time with the provider and more prescription medication management compared to visits made by non-obese persons.

METHODS

Obesity status was determined for 9,280 patient visits made by persons aged 18 years or older in the 2006 National Ambulatory Medical Care Survey. Multivariate analyses compared obese and non-obese visits, stratified by sex, for duration of the visit and the number of medications mentioned at the visit.

RESULTS

Average duration of visit was higher among visits with patients determined to be obese. However, these differences were not considered significant after statistical testing. Visits made by obese female patients were significantly more likely to involve more than two prescription medications (OR 1.26, 95% CI 1.05 - 1.51) and visits made by obese male patients were significantly more likely to involve more than two prescription medications (OR 1.46, 95% CI 1.16 - 1.83) as compared to visits made by non-obese patients.

CONCLUSION

Time spent with the provider was found to be greater among visits with obese patients, but not significantly different from visits with non-obese patients. The number of medications for each visit was found to be significantly greater for visits where the patient was considered to be obese. Increased time for the visit and increased numbers of medication for each visit translate into increased costs. These findings document the impact of obesity on our health care system and have great implications on medical care cost and planning.

摘要

背景

肥胖与发病率、死亡率和增加的医疗保健费用有关。很少有研究调查肥胖对门诊就诊的影响。本研究的目的是确定肥胖患者的门诊就诊是否需要与提供者花费更多时间和管理更多的处方药物,与非肥胖患者的就诊相比。

方法

在 2006 年全国门诊医疗调查中,确定了 9280 名 18 岁或以上的患者就诊时的肥胖状况。采用多变量分析比较了按性别分层的肥胖和非肥胖就诊的就诊时间和就诊时提到的药物数量。

结果

肥胖患者就诊的平均就诊时间较长。然而,经过统计学检验,这些差异并不显著。肥胖女性患者的就诊更有可能涉及两种以上的处方药物(OR 1.26,95%CI 1.05-1.51),而肥胖男性患者的就诊更有可能涉及两种以上的处方药物(OR 1.46,95%CI 1.16-1.83),与非肥胖患者的就诊相比。

结论

与非肥胖患者的就诊相比,肥胖患者就诊时与提供者的相处时间被发现更长,但没有显著差异。对于被认为肥胖的患者的每次就诊,所开药物的数量明显更多。就诊时间增加和每次就诊药物数量增加都会导致成本增加。这些发现记录了肥胖对我们医疗保健系统的影响,并对医疗保健成本和规划产生了重大影响。

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