Hospitals Prepare for Growing Ranks of Obese

As Americans keep getting bigger, hospitals are revamping themselves to accommodate an influx of obese patients:

When these patients check into a hospital, they are increasingly likely to find themselves in a room with a wider doorway than the 42-inch standard, a bed that holds up to 1,000 pounds and a ceiling lift system to move them to the bathroom.

Toilets in such a room are extra-sturdy and mounted to the floor instead of a wall.

The number of obesity, or bariatric surgeries performed each year has quadrupled since 2000, according to the American Society for Bariatric Surgery. The procedures generally involve surgically shrinking the stomach and bypassing the intestines to cause the patient to absorb less food.
The obese -- often defined as weighing 20 percent or more than medically recommended levels -- are also more likely to suffer from chronic medical ailments like diabetes and severe joint problems, bringing them into the hospital.

As a result, more hospitals are making capital investments to set up separate wings and whole floors for obese patients to keep up with demand.

"There is a huge volume of patients that need services, and until we get a better pill for weight loss, we have a big problem," said Daniel Jones, chief of bariatric surgery at Beth Israel Deaconess Hospital in Boston.

One-third of Americans are obese by U.S. health standards, which measure a person's body fat. The prevalence of obesity has doubled in that past 25 years, according to the U.S. Centers for Disease Control and Prevention, and experts predict a steady rise in coming years.

In January, the 585-bed Beth Israel hospital opened a new bariatric unit after gutting an entire a floor to construct 30 new rooms with specially-designed weight-bearing beds.

"Before, we just sent (bariatric patients) anywhere, like at the Holiday Inn," Jones said. "But the problem with that is you need the right equipment and medical staff who are specially trained."

Tenet Healthcare Corp., the second-biggest U.S. hospital chain, recently issued requirements for an obesity program -- including infrastructure-readiness -- at its 71 hospitals.

About 30 Tenet hospitals offer bariatric programs, according to Paulette Sams, director of general surgery.

The number of U.S. hospitals running obesity programs rose 45 percent to about 840 in 2004 from 2002, according to a survey of about 4,600 hospitals by the American Hospital Association trade group.

San Francisco's Laguna Honda Hospital, which with 1,000 beds is the largest U.S. long-term care facility, is building 24 new bariatric rooms designed with ceiling lifts that can route patients to extra-sturdy toilets.

"We are planning for the future, for this burgeoning obesity epidemic nationally," said Associate Administrator Lawrence Funk. "We would be remiss if we did not."

Laguna hopes the investment will pay off with a reduction in staff injuries, which are common when medical staff deal with the obese population without special equipment, Funk said.

At the 425-bed Froedtert and Medical College of Wisconsin, about 7 percent of new rooms from a recent expansion are specially equipped to handle bariatric patients.

John Balzer, vice president for planning and development, said the $3,200 per room in extra costs was insignificant.

"Even on a project with 10 percent of beds set up this way, it is difficult to show an impact on costs," he said.

Tenet's Sams said that when a hospital specializes in bariatrics, it attracts more of these patients, not just for surgeries, but also for the wide variety of medical care they typically need.

"You are going to have the large population show up at your door if you do these surgeries," she said.
Besides the boost in business, hospitals that specialize in bariatrics also benefit because government and private insurers are more likely to cover the procedures at attractive reimbursement rates.

The U.S. Medicare program recently said it would only pay for such surgeries at centers certified by medical societies, and private insurers are following that lead, officials said.

Hill-Rom, the hospital furniture unit of Hillenbrand Industries Inc., said sales of its bariatric line are growing rapidly, although it would not provide specific data.

"The first thing to increase was bariatric bed orders, and we expanded the product line to meet demand," said Design Director Dennis Gallant. "Trailing that is the redesign or design of rooms specifically for that purpose."

Tenet will often buy some larger furniture for general use because the additional cost is so small.

For example, Sams suggests replacing an operating table with one that can sustain 1,000 pounds, twice as much as the standard version.


"It's not that much more expensive," she said, "and you have hip surgery patients and heart patients that are extremely large."

These people should be running FEMA.