2011 Big Ten

Bariatrics

Bariatric patients continue to be a key patient segment that HMEs should target during 2011.

Last year, HME Business’s ongoing coverage highlighted bariatric patients as a key patient group providers should serve, and this has been such an important trend that we are adding it to this year’s Big 10. Bariatric patients are a population providers cannot ignore during 2011. An adult is considered to be obese if he or she has a body-mass index of 30 or more. As of 2010, 72 million Americans are now obese, according to the Centers for Disease Control. Now, about one-third of the residents of nine U.S. states are obese.

And the population of obese Americans is climbing. There are 2.4 million more obese people in America now than in 2007, and the number of states with an obesity prevalence of 30 percent or more has tripled in two years to nine in 2009.

Of course, there is a question of how obese a patient is. An adult is considered obese if he or she has a BMI of 30 or above. For example, a 5-foot-4 woman who weighs 174 pounds or more, or a 5-foot-10 man who weighs 209 pounds or more has a BMI of 30, and so is considered obese. But while America deals with its obesity epidemic, the number of bariatric patients is tougher to come by, especially for when it comes to morbidly obese Americans (those weighing 300 pounds or more, with a body mass index of 40 or more). Some figures put it as high as 9 million people.

Notably, there are a number of key DME product segments that cater to bariatric patients’ special needs. Bariatrics defines so many categories because bariatric patients have so many needs. They require special beds, special mattresses and support surfaces, to begin with. They have bath safety requirements that are both shared and unique from other patient groups, and they also have home access requirements that are unique, as well. In terms of mobility, they have unique walking aid, wheelchair and scooter requirements.

This offers opportunities for all sorts of HME providers looking to tap into this important patient population. Let’s take a look at a few:

Support Surfaces

Support surfaces and wound care are a particularly critical area for bariatric patients. Bariatric patients are at greater risk for pressure sores due to their size and immobility. There is a greater skin to weight ratio in these patients, confounded, in many cases, by their inability to turn every two hours. Add increased levels of moisture due to perspiration, and the situation is ideal for pressure sores.

Also, bariatric patients typically have lower levels of oxygen in their blood due to their obesity puts a strain on their hearts and lungs. This fosters the development of wounds since nutrition and oxygen can’t get to areas trying to fight off an ulcer.

Low air loss mattresses and alternating pressure mattresses can help prevent wounds by respectively providing airfl ow to help keep skin dry, and expanding and contracting sets of air cells to continually shift pressure. This is a key product segment for bariatric patients.

Beds

Providers also need to be concerned with what goes under that support surface. In the very basic sense, bariatric patients need beds that can support both their weight and size. Durability is a key factor and providers need to ensure that the bed they are provided is designed for the patient’s weight. Also, bariatric beds need to be safe. If a bariatric patient falls out of bed, he or she can sustain significant injuries. So bariatric beds are lower to the ground to prevent injurious falls.

Besides safety, bariatric beds also need to deliver decent comfort. Because bariatric patients are likely to spend more time in their beds, the beds should be able to provide functionality such as being able to articulate into a sitting position so that the patient can conduct activities besides sleeping while in bed.

Bath Safety

Bath safety is another important area of bariatric care. Bariatric patients are subject to the same fall risks as seniors, and, in some cases, the results of their falls can be more devastating given their weight. Also, they need bathroom fixtures that will support their weight.

So, sturdy grab rails that can support the patient’s weight should be strategically throughout the bathroom. The toilet must be a special bariatric unit that supports their weight, so some bariatric toilets can support as much as 850 pounds. Bariatric toilets are also often taller so that the bariatric patient does not have to drop down on them. Also a shower chair or bench is important. The prospect of sitting in a tub also has injury potential so bariatric patients must use a shower, but should have a chair to prevent a slip and fall.

Whether it is bath safety, or support surfaces, or beds, or other categories such as mobility, lift chairs, home access or other DME product segments, bariatric patients will continue to be a key population providers should be serving during 2011.

Points to Remember

  • 72 million Americans are obese and possibly 9 million of them are morbidly obese.
  • This creates a key patient population that providers must be serving.
  • Bariatric patients’ conditions, as well as their co-morbidities, mean they need a range of services from HME providers.
  • One key segment is support surfaces, such as low air loss and alternating pressure mattresses, which can help prevent pressure ulcers in bariatric patients.
  • Other keys segment are bariatric beds and bathing solutions that both must be sturdier and safer.

This article originally appeared in the January 2011 issue of HME Business.

About the Author

David Kopf is the Editor of HME Business.

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