Determining the rate of obesity documentation in a division of general internal medicine at a tertiary care medical center

Abstract

Background: Obesity is a leading cause of preventable deaths in the United States, likely second only to tobacco-related diseases. However, studies have shown that the formal diagnosis rate is low, at 19.9%. Furthermore, of the patients with a diagnosis of obesity, only 22.6% receive a treatment plan. Objective: The objective was to determine rates of identification and diagnosis of obesity and referral for counseling in an ambulatory general internal medicine practice. Design: The electronic health records (EHR)of patients seen and examined for a 6-month period were searched for obesity-related terms (ORTs) which included: obese, overweight, weight-related issues, and elevated body mass index (BMI). Patients: All patients with a documented BMI of more than 30 kg/m2 who underwent a medical examination in the Division of General Internal Medicine at Mayo Clinic in Rochester, Minnesota, from October 1, 2012, through March 31, 2013, constituted the study population. Main Measures: Of 7484 patients seen for a medical examination, 2044 (27.3%) had a BMI more than 30 kg/m2. Of these, 946 (46.3%) were female. Key Results: The mean BMI was 34.8 kg/m2 (range, 30.0–64.4), and the mean age was 60.7 years (range, 18.5–94.6). Only 473 patients (23.1%) had the International Classification of Disease, Ninth Revision (ICD-9), code for diagnosis of obesity: Class 1 in 192 (41%), class 2 in 162 (34%), and class 3 in 119 (25%). Of the remaining 1571 patients with a BMI more than 30 kg/m2 but wi…