Kraschnewski Jennifer, Yeh Hsin-Chieh, Francis Erica, Kong Lan, Lehman Erik, Rovito Stephanie, Poger Jennifer, Bryce Cindy
Penn State College of Medicine, Hershey, Pennsylvania, USA.
Johns Hopkins School of Medicine, Baltimore, MD, USA.
Clin Obes. 2021 Feb;11(1):e12426. doi: 10.1111/cob.12426. Epub 2020 Nov 4.
Obesity is a leading public health concern. The Centers for Medicare and Medicaid Services implemented a healthcare procedure code for intensive behavioural therapy (IBT) in 2012 to facilitate payment for addressing obesity in primary care settings, followed by universal coverage by insurers for all adults. Our objective was to understand utilization of IBT from 2009 to 2017 in patients with a diabetes diagnosis. Leveraging electronic health record data from the PaTH Clinical Data Research Network (CDRN), a partnership of six health systems, utilization of IBT was summarized at a yearly basis. The trend of IBT prevalence was examined for patients with diabetes by gender, race, age (>=65 vs <65) and rurality. A total of 205, 913 patients were included. While utilization of IBT is low (0.24% in 2017), use of IBT increased among patients with commercial insurance and Medicaid (codes S9449 and S9470) in 2011, and among patients with Medicare (code G0447) in 2012. IBT users tended to be less than 65 years of age, female, non-White (Black or Hispanic), and reside in urban areas. Overall, use of IBT in patients with diabetes remains low. Future work is necessary to understand the impact of IBT and, if effective, how to increase use within primary care.
肥胖是一个主要的公共卫生问题。医疗保险和医疗补助服务中心于2012年实施了一项针对强化行为疗法（IBT）的医疗程序代码，以便于在初级保健机构中为解决肥胖问题支付费用，随后保险公司对所有成年人实行了全面覆盖。我们的目标是了解2009年至2017年期间糖尿病诊断患者对IBT的使用情况。利用来自PaTH临床数据研究网络（CDRN）（六个卫生系统的合作项目）的电子健康记录数据，每年总结IBT的使用情况。按性别、种族、年龄（≥65岁与＜65岁）和城乡差异，对糖尿病患者的IBT患病率趋势进行了研究。共纳入了205,913名患者。虽然IBT的使用率较低（2017年为0.24%），但2011年商业保险和医疗补助患者（代码S9449和S9470）以及2012年医疗保险患者（代码G0447）对IBT的使用有所增加。IBT使用者往往年龄小于65岁、为女性、非白人（黑人或西班牙裔），且居住在城市地区。总体而言，糖尿病患者对IBT的使用仍然较低。有必要开展进一步工作，以了解IBT的影响，以及如果有效，如何在初级保健中增加其使用。
