Obese and overweight patients do not appear to receive inferior health care, compared with normal-weight patients, according to an analysis of almost 70,000 patients.
In fact, patients with a higher body mass index may be more likely to undergo lipid screening and hemoglobin
A1c testing; vaccination for influenza and pneumococcus; and screening for breast, colorectal, and cervical cancer, said Dr. Virginia W. Chang of the University of Pennsylvania, Philadelphia, and her associates.
They studied data from nationally representative samples of 36,122 Medicare beneficiaries and 33,550 Veterans Affairs patients. The prevalence of obesity was 20% in the Medicare group and 39% in the VA group. Eight quality-of-care measures were examined: whether diabetic patients received eye exams, lipid screening, and HbA1c tests; whether appropriate patients received influenza and pneumococcal vaccines; and whether appropriate patients were offered mammography, Pap smears, and colorectal cancer screening.
Across all measures in both samples, “there was no instance in which obese or overweight individuals were estimated to have significantly lower odds of recommended care relative to normal-weight individuals,” the researchers wrote (JAMA 2010;303:1274-81).
“Our findings may not be generalizable to quality of care in younger populations,” the researchers noted.
The study was supported by the Veterans Health Administration and the Robert Wood Johnson Foundation. No financial conflicts were reported.