Do obese patient receive worse healthcare?

January 01, 0001

Do obese patient receive worse healthcare?

Obesity is a complex problem that can carry stigma and be associated with negative attitudes in others, including care providers. These US researchers examined whether obese patients receive lower quality of care using performance on common outpatient quality. Performance measures were examined using data from the Medicare Beneficiary Survey (1994-2006, n = 36 122) and using data from an ongoing performance-evaluation program (2003-2004) in the Veterans Health Administration (VHA, n = 33,550). Performance outcomes included diabetes care (eye examination, HbA1c,and lipid screening), pneumococcal vaccination, influenza vaccination, screening mammography, colorectal cancer screening, and cervical cancer screening.

The researchers report: "We found no evidence that obese or overweight patients were less likely to receive recommended care relative to normal-weight patients. Moreover, success rates were marginally higher for obese and/or overweight patients on several measures. The most notable differentials were observed for recommended diabetes care among Medicare beneficiaries. Comparing obese vs normal-weight patients with diabetes, obese patients were more likely to receive recommended care on lipid screening (72% vs 65%, odds ratio, 1.37) and HbA1c testing (74% vs 62%, odds ratio, 1.73). All analyses were adjusted for sociodemographic factors, health status, clinical complexity, and visit frequency."

The authors concluded: "Among samples of patients from the Medicare and VHA populations, there was no evidence across 8 performance measures that obese or overweight patients received inferior care when compared with normal-weight patients. Being obese or overweight was associated with a marginally higher rate of recommended care on several measures."

This study reassures us that, despite concerns about stigma and negative attitudes toward obese people, obese patients received the same or marginally better care based on some performance measures.

For the full abstract, click here.

JAMA 303(13):1274-1281, 7 April 2010 © 2010 American Medical Association
Quality of Care Among Obese Patients. Virginia W. Chang, David A. Asch, Rachel M. Werner.

Category: HSR. Health Services Research. Keywords: obese, Medicare, VHA, diabetic care, HbA1c, performance measures, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 27 April 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.