Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
Fam Pract. 2021 Sep 25;38(5):576-581. doi: 10.1093/fampra/cmab019.
It is recommended that primary care-based physicians refer children with overweight and obesity to multidisciplinary paediatric obesity management, which can help to improve weight and health.
To determine predictors of referral to multidisciplinary paediatric obesity management.
This retrospective, population-level study included physicians who could refer 2-17 years old with a body mass index ≥85th percentile to one of three multidisciplinary paediatric obesity management clinics in Alberta, Canada. Physician demographic and procedural data were obtained from Practitioner Claims and Provider Registry maintained by Alberta Health from January 2014 to December 2017. Physician characteristics were compared based on whether they did or did not refer children for obesity management. Univariable and multivariable logistic regression models analysed associations between physician characteristics and referral making.
Of the 3863 physicians (3468 family physicians, 395 paediatricians; 56% male; 49.3 ± 12.2 years old; 22.3 ± 12.6 years since graduation) practicing during the study period, 1358 (35.2%) referred at least one child for multidisciplinary paediatric obesity management. Multivariable regression revealed that female physicians (versus males) [odds ratio (OR): 1.68, 95% confidence interval (CI): 1.46-1.93; P < 0.0001], paediatricians (versus family physicians) (OR: 4.89, 95% CI: 3.85-6.21; P < 0.0001) and urban-based physicians (versus non-urban-based physicians) (OR: 2.17, 95% CI: 1.79-2.65; P < 0.0001) were more likely to refer children for multidisciplinary paediatric obesity management.
Approximately one-third of family physicians and paediatricians referred children for multidisciplinary paediatric obesity management. Strategies are needed to improve referral practices for managing paediatric obesity, especially among male physicians, family physicians and non-urban-based physicians as they were less likely to refer children.
建议初级保健医生将超重和肥胖的儿童转介到多学科儿科肥胖管理中心，这有助于改善体重和健康状况。
确定转介到多学科儿科肥胖管理的预测因素。
本回顾性、人群水平研究纳入了加拿大艾伯塔省的三家多学科儿科肥胖管理诊所可转介年龄为 2-17 岁、体重指数≥第 85 百分位数的儿童的医生。从 2014 年 1 月至 2017 年 12 月，艾伯塔省卫生保健部门从医生索赔和提供者登记处获取医生的人口统计学和程序数据。根据是否为肥胖管理转介儿童，比较医生特征。单变量和多变量逻辑回归模型分析了医生特征与转介行为之间的关联。
在研究期间执业的 3863 名医生（3468 名家庭医生，395 名儿科医生；56%为男性；49.3±12.2 岁；22.3±12.6 年毕业）中，有 1358 名（35.2%）至少为一名儿童转介了多学科儿科肥胖管理。多变量回归显示，女性医生（相对于男性）[比值比（OR）：1.68，95%置信区间（CI）：1.46-1.93；P<0.0001]、儿科医生（相对于家庭医生）（OR：4.89，95%CI：3.85-6.21；P<0.0001）和城市医生（相对于非城市医生）（OR：2.17，95%CI：1.79-2.65；P<0.0001）更有可能为儿童转介多学科儿科肥胖管理。
大约三分之一的家庭医生和儿科医生为儿童转介了多学科儿科肥胖管理。需要采取策略来改善儿科肥胖管理的转介实践，特别是在男性医生、家庭医生和非城市医生中，因为他们不太可能为儿童转介。
