2013 Survey Findings of Children’s Hospitals Obesity
In order to better understand the children’s hospital response to
the childhood obesity epidemic, the Children’s Hospital
Association fielded a survey of obesity services at member hospitals.
The objectives of collecting, analyzing and disseminating these data are
Establish a baseline understanding of obesity services provided by
Children’s Hospital Association member hospitals
Support respondent’s interest in customized benchmarking to
Inform strategic planning for the Association’s work in
childhood obesity in order to advance the strengths and support the
needs of our member institutions
Respondents to the survey represent 118 children’s hospitals
and 85 comprehensive weight management departments (Stage 3
Majority of patients seen are severely obese
The majority of patients receiving comprehensive weight
management services in children’s hospitals have a BMI that
classifies them as obese (31%) or severely obese (58%), demonstrating
that as in other subspecialties, children’s hospitals are seeing
the sickest kids.
Caseload is increasing
Of those offering comprehensive weight management services, 60
percent report an increase in caseload over the last three years.
Multidisciplinary, comprehensive services are the norm
Among the 85 respondents offering comprehensive weight
management services, there is uniformity in what is being offered with
nutrition therapy provided by nearly all respondents (99%), followed by
medical assessment (92%), medical monitoring (89%), behavior counseling
(86%) and exercise or physical therapy (80%).
Weight management services are not financially self-sustaining
Most respondents (84%) report operating at a loss in 2012, with
15 percent breaking even and only 2 percent (one program) reporting
operating with revenue exceeding expenses. The current payor mix for
these programs, in aggregate, favors Medicaid or other public insurance
(53%), with just over one third of patients using commercial insurance
(35%). However, it is important to note the range that exists among
hospitals, as some programs rely 100 percent on Medicaid, while others
operate 100 percent self-pay programs.
Programs believe they meet Federal recommendations
The US Preventative Services Task Force (USPSTF) recommends
weight management programs offer 25 contact hours over six months for
successful outcomes. Two-thirds of respondents with programs agree their
Stage 3 program meets USPSTF guidelines, but there is very little
uniformity in program length. In fact, only about 40 percent report
offering programs of six months or longer, demonstrating the diversity
in how weight management programs are designed.
Policies for identification of obesity are lacking
The survey findings show less than half of all respondents
(42%) have a policy in all hospital settings – inpatient,
outpatient and primary care clinics – to identify obesity.
Identification is not only important for treatment of the obesity and
its co-morbid conditions, but to ensure that obese patients are
receiving safe and appropriate care whatever the reason for their
Childhood obesity is an issue of community need
A majority of respondents (61%) report obesity has been
identified as an area of concern on their hospital’s most recent
community health needs assessment.
Thank you to the 118 respondents and hospitals that made this report
the Principal Findings
Using this Report
Use this PowerPoint
version of the data report to present the findings to
colleagues and administration within your institution. If you have
questions or want to discuss opportunities for benchmarking reports,
please contact Stacy
Biddinger, assistant director, Child Health Advocacy.