References
Impact of increasing obesity on primary health carers: an Australian perspective
Abstract
Increasing levels of obesity in Australia are having a direct impact on those associated with primary care and patient transport.
Whether the patient movement is undertaken in the uncontrolled environment of the home or the controlled environment of the hospital, design features generally limit the use of equipment and the application of safe handling procedures.
Ambulance and fire services are increasingly developing policies and procedures that address the movement of obese and morbidly obese (bariatric) patients and the purchase and use of equipment. Yet the efficacy of these procedures is hampered by the absence of a standard definition of the term ‘bariatric’. Various definitions of ‘bariatric’ are applied in different sectors and risk-based approaches rather than those based on weight, body dimensions or BMI may be more useful.
Substantially more work is required to inform the development of intervention strategies that will lead to significant and sustained risk reduction. Further work is also needed to quantify the frequency of bariatric patient movement within the emergency services across Australia. A clear representation of the journey and the interfaces between the agencies and carers and their respective roles would assist with defining the problem and understanding the solutions.
Growing levels of obesity in many westernised countries are having a direct impact on health care systems. The impact is felt to a high degree among primary carers and emergency services personnel.
In the past 20 years obesity prevalence has increased by half in the United Kingdom and the United States and more than doubled in Australia and New Zealand. Some 20–24% of adults in the United Kingdom and Ireland and Australia are obese (Organisation for Economic Co-operation and Development, 2011).
A proportion of the obese population become morbidly obese (bariatric), i.e. have a body mass index (BMI) 40 kg/m2 or more. Between 1993 and 2011, the prevalence of morbid obesity in England was consistently higher among women (increasing from 1.4% in 1993 to 3.2% in 2011) than among men (increasing from 0.2% in 1993 to 1.7% in 2011) and the prevalence of morbid obesity in England is predicted to rise over the next 20–30 years (Public Health England, 2013). In South Eastern Australia, the prevalence of morbid obesity among women increased from 2.5% to 4.2% during the decade between 1993–7 and 2004–8 (Pasco et al, 2013) and Australia is now ranked as one of the fattest developed nations (Government of Australia, 2009).
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