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Multidisciplinary Approach to Obesity Management: A Case Report
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Physician-related predictors of referral for multidisciplinary paediatric obesity management: a population-based
Nicole D Gehring1, Maryam Kebbe2, Sarah Rathwell3
1Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Insights
Female physicians, pediatricians, and urban-based doctors are more likely to refer children with obesity to specialized management. Strategies are needed to increase referrals from male, family, and non-urban physicians for better pediatric obesity care.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Childhood overweight and obesity require effective management strategies.
- Multidisciplinary paediatric obesity management is recommended for improving health outcomes.
- Primary care physicians play a crucial role in referring children to these specialized services.
Purpose of the Study:
- To identify factors associated with physician referrals to multidisciplinary paediatric obesity management.
- To understand predictors influencing the decision-making process for paediatric obesity referrals.
Main Methods:
- Retrospective, population-level study analyzing physician referral data in Alberta, Canada (2014-2017).
- Inclusion criteria: Physicians referring children aged 2-17 with BMI ≥85th percentile.
- Statistical analysis included univariable and multivariable logistic regression to identify referral predictors.
Main Results:
- 35.2% of physicians referred at least one child for obesity management.
- Female physicians (OR: 1.68), paediatricians (OR: 4.89), and urban-based physicians (OR: 2.17) showed significantly higher referral rates.
- Referral likelihood varied based on physician demographics and practice location.
Conclusions:
- Referral rates for paediatric obesity management are suboptimal, with approximately one-third of physicians participating.
- Targeted interventions are necessary to enhance referral practices among male, family physicians, and non-urban-based physicians.
- Improving referral consistency is vital for effective management of childhood obesity.
Background:
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.
Objective:
To determine predictors of referral to multidisciplinary paediatric obesity management.
Methods:
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.
Results:
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.
Conclusions:
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.
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