Referrals for pediatric weight management: the importance of proximity

Abstract

Background: Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity.

Methods: All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada) between April, 2005 and April, 2009.

Results: Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4) were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455) or beyond (distant; n = 100) the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children.

Conclusion: Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.

Figure 1

Spatial distribution of clients referred to the pediatric weight management centre from April, 2005 to April, 2009 from within and beyond the Edmonton Census Metropolitan Area (ECMA) presented using Single Link Indicator (SLI) coordinates. Note: Of the 555 referrals received by the pediatric weight management centre, 548 are graphically depicted in Figure 1. An additional seven referrals were received for clients living outside the province of Alberta.