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Healthcare
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Hospital Care and Outcomes for Obese Patients
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Hospital Care and Outcomes for Obese Patients

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Perioperative Care".

Deadline for manuscript submissions: closed (26 February 2021) | Viewed by 12083

Special Issue Editors

Dr. Tracy Comans

E-Mail Website
Guest Editor
Centre for Health Services Research, The University of Queensland, Brisbane, Australia
Interests: health economics; quality of life; care of older people; rehabilitation
Special Issues, Collections and Topics in MDPI journals
Dr. Adrienne Young

E-Mail Website
Guest Editor
Royal Brisbane and Women's Hospital, Brisbane, Australia
Interests: obesity; bariatrics; hospital care; cost of care

Special Issue Information

Dear Colleagues,

Obesity is a known risk factor for prolonged hospital stays and worse outcomes following medical intervention. Rising levels of obesity impact the way hospitals can deliver care for inpatients. This Special Issue is concerned with measuring the impact of obesity on resource use and models of care in hospitals. Key outcomes of interest include the use of specialized equipment such as bariatric beds, impact on nursing care, staff injury, length of stay, adverse events, and patient-related outcomes.

Dr. Tracy Comans
Dr. Adrienne Young
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Hospitals
  • Obesity
  • Models of care

Published Papers (5 papers)

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Research

11 pages, 603 KiB  
Article
Improving Accurate Blood Pressure Cuff Allocation in Patients with Obesity: A Quality Improvement Initiative
by Victoria Eley, Aaron Khoo, Christine Woods and Andre van Zundert
Healthcare 2021, 9(3), 323; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9030323 - 13 Mar 2021
Cited by 1 | Viewed by 2109
Abstract
Accurate noninvasive blood pressure (NIBP) measurement requires use of an appropriately sized cuff. We aimed to improve the perioperative allocation of NIBP cuffs in patients with Class II–III obesity. In the baseline evaluation, we measured the mid-arm circumference (MAC) of 40 patients with [...] Read more.
Accurate noninvasive blood pressure (NIBP) measurement requires use of an appropriately sized cuff. We aimed to improve the perioperative allocation of NIBP cuffs in patients with Class II–III obesity. In the baseline evaluation, we measured the mid-arm circumference (MAC) of 40 patients with BMI > 35 kg/m2, documenting the corresponding cuff allocated by pre-operative nurses. The intervention consisted of the introduction of cuff allocation based on MAC measurement and augmented NIBP cuff supplies. We completed a re-evaluation and evaluation of the intervention by staff survey, using 5-point Likert scales and free text comments. At baseline, the correct cuff was allocated in 9 of 40 patients (22.5%). During the intervention, education occurred in 54 (69.2%) peri-operative nursing staff. Upon re-evaluation, the correct cuff was allocated in 30 of 40 patients (75.0%), a statistically significant improvement (χ2 = 22.1, p < 0.001). Ninety-three of 120 staff surveys were returned (78%). Eleven out of 18 preoperative staff surveyed (61.1%) felt confident measuring the arm and selecting the correct cuff. Six (33%) agreed that taking the arm measurement added a lot of extra work. Equipment shortages, accuracy concerns, and clinical workarounds were reported by staff. Our intervention increased the proportion of correct cuffs allocated, but equipment and practical issues persist with NIBP cuff selection in obese patients. Full article
(This article belongs to the Special Issue Hospital Care and Outcomes for Obese Patients)
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14 pages, 879 KiB  
Article
Patient Perceptions of a Group-Based Lifestyle Intervention for Overweight Women with Urinary Incontinence: A Qualitative Descriptive Study
by Shelley Roberts, Zara Howard, Kelly A. Weir, Jennifer Nucifora, Nadine Baker, Leanne Smith, Heidi Townsend and Lynda Ross
Healthcare 2021, 9(3), 265; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9030265 - 02 Mar 2021
Cited by 1 | Viewed by 1989
Abstract
Urinary incontinence (UI) affects many women and impacts quality of life. Group-based interventions may be an effective and efficient method for providing UI care; however, interventions must be acceptable to patients to have an impact. This study aimed to explore patients’ perceptions of [...] Read more.
Urinary incontinence (UI) affects many women and impacts quality of life. Group-based interventions may be an effective and efficient method for providing UI care; however, interventions must be acceptable to patients to have an impact. This study aimed to explore patients’ perceptions of an exercise training and healthy eating group program (ATHENA) for overweight and obese women with UI. This qualitative descriptive study involved semi-structured interviews with a subset of participants sampled from a feasibility study of ATHENA. The ATHENA intervention was co-developed with end-users and implemented in Women’s Health Physiotherapy services at an Australian hospital. Interviews were recorded, transcribed and analysed thematically. Eleven female patients participated (mean ± SD age 54.2 ± 9.9 years; body mass index 30.5 ± 3.25 kg/m2). Participants found ATHENA highly acceptable, with three themes emerging from interviews: (1) Participants’ journey of change through ATHENA, describing the shifts in knowledge, attitudes, behaviours and symptoms participants experienced; (2) High satisfaction with ATHENA, including educational content, exercise components and delivery style; and (3) Group setting integral to ATHENA’s success, with participants providing support, building friendships, and facilitating each other’s learning. Overall, ATHENA was acceptable to participants, who provided each other with peer support; an unexpected moderator to ATHENA’s success. Full article
(This article belongs to the Special Issue Hospital Care and Outcomes for Obese Patients)
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14 pages, 382 KiB  
Article
Impact of Nutrition Care Process Documentation in Obese Children and Adolescents with Metabolic Syndrome and/or Non-Alcoholic Fatty Liver Disease
by Gadah Mujlli, Dara Aldisi, Ghadeer S. Aljuraiban and Mahmoud M. A. Abulmeaty
Healthcare 2021, 9(2), 188; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9020188 - 09 Feb 2021
Viewed by 2496
Abstract
This study evaluated the Nutrition Care Process documentation used by dietitians for obese pediatric patients diagnosed with metabolic syndrome (MetS) and/or non-alcoholic fatty liver disease (NAFLD) and its impact on the achievement of nutritional goals. This retrospective cohort study utilized data retrieved from [...] Read more.
This study evaluated the Nutrition Care Process documentation used by dietitians for obese pediatric patients diagnosed with metabolic syndrome (MetS) and/or non-alcoholic fatty liver disease (NAFLD) and its impact on the achievement of nutritional goals. This retrospective cohort study utilized data retrieved from three tertiary care hospitals in Riyadh. A total of 142 obese pediatric patients aged 8–18 years diagnosed with NAFLD and/or MetS were evaluated. Data on weight, height, blood pressure (BP), lipid profile, and liver enzymes were collected. A validated audit was used to assess the documentation quality. Twenty-seven (46.6%) dietitian notes received a high score, 21 (36.2%) received a medium score, and 10 (17.2%) received a low score. There was no significant effect of dietitian audit scores on nutritional outcomes, however, the change in body mass index from 6 to 12 months follow-up period was inversely correlated with the audit score (r = −0.761, p = 0.007), and alkaline phosphatase was inversely correlated with the audit score (r = −0.819, p = 0.013). In conclusion, there was a clear variation in the quality of dietitians’ documentation and the impact of documentation scores on nutritional outcomes. Full article
(This article belongs to the Special Issue Hospital Care and Outcomes for Obese Patients)
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13 pages, 2988 KiB  
Article
Exploring the Impact of Obesity on Health Care Resources and Coding in the Acute Hospital Setting: A Feasibility Study
by Winnie S. Y. Tan, Adrienne M. Young, Alexandra L. Di Bella, Tracy Comans and Merrilyn Banks
Healthcare 2020, 8(4), 459; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare8040459 - 04 Nov 2020
Cited by 1 | Viewed by 2029
Abstract
Obesity is costly, yet there have been few attempts to estimate the actual costs of providing hospital care to the obese inpatient. This study aimed to test the feasibility of measuring obesity-related health care costs and accuracy of coding data for acute inpatients. [...] Read more.
Obesity is costly, yet there have been few attempts to estimate the actual costs of providing hospital care to the obese inpatient. This study aimed to test the feasibility of measuring obesity-related health care costs and accuracy of coding data for acute inpatients. A prospective observational study was conducted over three weeks in June 2018 in a single orthopaedic ward of a metropolitan tertiary hospital in Queensland, Australia. Demographic data, anthropometric measurements, clinical characteristics, cost of hospital encounter and coding data were collected. Complete demographic, anthropometric and clinical data were collected for all 18 participants. Hospital costing reports and coding data were not available within the study timeframe. Participant recruitment and data collection were resource-intensive, with mobility assistance required to obtain anthropometric measurements in more than half of the participants. Greater staff time and costs were seen in participants with obesity compared to those without obesity (obesity: body mass index ≥ 30), though large standard deviations indicate wide variance. Data collected suggest that obesity-related cost and resource use amongst acute inpatients require further exploration. This study provides recommendations for protocol refinement to improve the accuracy of data collected for future studies measuring the actual cost of providing hospital care to obese inpatients. Full article
(This article belongs to the Special Issue Hospital Care and Outcomes for Obese Patients)
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8 pages, 370 KiB  
Article
Underreporting of Obesity in Hospital Inpatients: A Comparison of Body Mass Index and Administrative Documentation in Australian Hospitals
by Alexandra L Di Bella, Tracy Comans, Elise M Gane, Adrienne M Young, Donna F Hickling, Alisha Lucas, Ingrid J Hickman and Merrilyn Banks
Healthcare 2020, 8(3), 334; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare8030334 - 11 Sep 2020
Cited by 7 | Viewed by 2709
Abstract
Despite its high prevalence, there is no systematic approach to documenting and coding obesity in hospitals. This study aimed to determine the prevalence of obesity among inpatients, the proportion of obese patients recognised as obese by hospital administration, and the cost associated with [...] Read more.
Despite its high prevalence, there is no systematic approach to documenting and coding obesity in hospitals. This study aimed to determine the prevalence of obesity among inpatients, the proportion of obese patients recognised as obese by hospital administration, and the cost associated with their admission. A cross-sectional study was undertaken in three hospitals in Queensland, Australia. Inpatients present on three audit days were included in this study. Data collected were age, sex, height, and weight. Body mass index (BMI) was calculated in accordance with the World Health Organization’s definition. Administrative data were sourced from hospital records departments to determine the number of patients officially documented as obese. Total actual costing data were sourced from hospital finance departments. From a combined cohort of n = 1327 inpatients (57% male, mean (SD) age: 61 (19) years, BMI: 28 (9) kg/m2), the prevalence of obesity was 32% (n = 421). Only half of obese patients were recognised as obese by hospital administration. A large variation in the cost of admission across BMI categories prohibited any statistical determination of difference. Obesity is highly prevalent among hospital inpatients in Queensland, Australia. Current methods of identifying obesity for administrative/funding purposes are not accurate and would benefit from reforms to measure the true impact of healthcare costs from obesity. Full article
(This article belongs to the Special Issue Hospital Care and Outcomes for Obese Patients)
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