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The time burden of overweight and obesity in primary care

BACKGROUND: Overweight and obesity are associated with many conditions treated in primary care. Our objectives were: 1) to determine the frequency of weight-related conditions in a national sample of outpatient visits in the United States; 2) to establish the percentage of diagnosis codes and visit...

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Autores principales: Tsai, Adam G, Abbo, Elmer D, Ogden, Lorraine G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175444/
https://www.ncbi.nlm.nih.gov/pubmed/21846407
http://dx.doi.org/10.1186/1472-6963-11-191
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author Tsai, Adam G
Abbo, Elmer D
Ogden, Lorraine G
author_facet Tsai, Adam G
Abbo, Elmer D
Ogden, Lorraine G
author_sort Tsai, Adam G
collection PubMed
description BACKGROUND: Overweight and obesity are associated with many conditions treated in primary care. Our objectives were: 1) to determine the frequency of weight-related conditions in a national sample of outpatient visits in the United States; 2) to establish the percentage of diagnosis codes and visit codes attributable to overweight and obesity; and 3) to estimate time spent to address these conditions, including time attributable to overweight and obesity itself. METHODS: We analyzed primary care visits from the 2005 and 2006 National Ambulatory Medical Care Survey (NAMCS) in the United States. Weight-related conditions included diabetes, hypertension, hyperlipidemia, obesity, cardiovascular disease, osteoarthritis, and low back pain. We used multivariable logistic regression to estimate an odds ratio for each weight-related condition, which we then converted to an attributable fraction (AF). The AF represents the percentage of diagnosis codes and visit codes attributable to excess weight for that condition. We then divided total visit time among all diagnoses and clinical items addressed at the primary care visit. Finally, to calculate the time attributable to overweight and obesity, we multiplied the AFs by the time spent on each weight-related condition. RESULTS: The total number of clinical items (diagnoses + medications + tests + counseling) was estimated to be 7.6 per patient, of which 2.2 were weight-related. Of a total visit time of 21.77 minutes, time spent addressing weight-related conditions was 5.65 minutes (30%), including 1.75 minutes (8.0%) attributable to overweight and obesity. CONCLUSIONS: Approximately 8% of time from primary care visits is attributable to overweight and obesity. This estimate is conservative because the NAMCS only allows for coding of three diagnoses addressed per visit. Estimates of the time burden of overweight and obesity provide data to prioritize weight management for prevention and treatment.
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spelling pubmed-31754442011-09-21 The time burden of overweight and obesity in primary care Tsai, Adam G Abbo, Elmer D Ogden, Lorraine G BMC Health Serv Res Research Article BACKGROUND: Overweight and obesity are associated with many conditions treated in primary care. Our objectives were: 1) to determine the frequency of weight-related conditions in a national sample of outpatient visits in the United States; 2) to establish the percentage of diagnosis codes and visit codes attributable to overweight and obesity; and 3) to estimate time spent to address these conditions, including time attributable to overweight and obesity itself. METHODS: We analyzed primary care visits from the 2005 and 2006 National Ambulatory Medical Care Survey (NAMCS) in the United States. Weight-related conditions included diabetes, hypertension, hyperlipidemia, obesity, cardiovascular disease, osteoarthritis, and low back pain. We used multivariable logistic regression to estimate an odds ratio for each weight-related condition, which we then converted to an attributable fraction (AF). The AF represents the percentage of diagnosis codes and visit codes attributable to excess weight for that condition. We then divided total visit time among all diagnoses and clinical items addressed at the primary care visit. Finally, to calculate the time attributable to overweight and obesity, we multiplied the AFs by the time spent on each weight-related condition. RESULTS: The total number of clinical items (diagnoses + medications + tests + counseling) was estimated to be 7.6 per patient, of which 2.2 were weight-related. Of a total visit time of 21.77 minutes, time spent addressing weight-related conditions was 5.65 minutes (30%), including 1.75 minutes (8.0%) attributable to overweight and obesity. CONCLUSIONS: Approximately 8% of time from primary care visits is attributable to overweight and obesity. This estimate is conservative because the NAMCS only allows for coding of three diagnoses addressed per visit. Estimates of the time burden of overweight and obesity provide data to prioritize weight management for prevention and treatment. BioMed Central 2011-08-17 /pmc/articles/PMC3175444/ /pubmed/21846407 http://dx.doi.org/10.1186/1472-6963-11-191 Text en Copyright ©2011 Tsai et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Tsai, Adam G
Abbo, Elmer D
Ogden, Lorraine G
The time burden of overweight and obesity in primary care
title The time burden of overweight and obesity in primary care
title_full The time burden of overweight and obesity in primary care
title_fullStr The time burden of overweight and obesity in primary care
title_full_unstemmed The time burden of overweight and obesity in primary care
title_short The time burden of overweight and obesity in primary care
title_sort time burden of overweight and obesity in primary care
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175444/
https://www.ncbi.nlm.nih.gov/pubmed/21846407
http://dx.doi.org/10.1186/1472-6963-11-191
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