Obesity Weighs on Procurement Options
Though its growth among Americans seems to be starting to slow down, obesity has become a massive phenomenon these last two decades, and sadly, it is increasing in the still slimmer populations in many European, Latin American and Asian countries. Extreme obesity strikes about 4.7% of Americans. This has consequences all around the hospital as the Washington Post reports today (free registration required). Sofas or benches become necessary to let larger people sit down in waiting rooms, while beds and exam tables need to be strenghtened. Even needles need to be lenghtened and gowns widened.
But adapting to obesity does not stop at furniture, clothing and consumables. MD Buyline listed some ways medical imaging has to take obesity into account, through the whole range of radiographs, ultrasound, CT, MR imaging, nuclear medicine and interventional radiology. Manufacturers are introducing devices with increased ultrasound penetration or wider bores, as well as larger spaces. And beyond sturdiness and dimensional contraints, a more important issue is the ability to get proper results from exams and to perform common operations. In a December 2004 Article, the WaPo already reported how inconclusive ultrasound exams performed on obese people lead to CT scans just to confirm a belly pain is due to an appendicitis.
What radiologists call “limited by body habitus (LBBH) leads to harder and longer-to-reach, more expensive diagnoses. Doctors sometimes have to either wait and see or perform intrusive procedures to know what’s going on with a patient. A 2004 study published in the Annals of Internal Medicine concluded that mammography accuracy is lower for pregnant women. Radiology Rounds, a Newsletter by the Massachusetts General Hospital Department of Radiology, provides further details and revealing images (for what they don’t show).
With some airlines charging larger people for two seats, it may prove tempting to pass higher healthcare costs generated by obesity on to overweight people. Before that political issue is resolved, hospitals will have to reconcile standardization and cost-cutting efforts with the need to accommodate larger and heavier patients. These statistics can help you assess the needs in your state (for some states data by county is also available).
January 3, 2006 Related topics: Quality, Safety, Errors, Bariatrics & Obesity, Diagnostic, Radiology, Obstetrics, Gynecology & Neonatology, Standardization