Milwaukee Journal Sentinel
July 17, 2010
From hamburgers to houses, it seems everything is getting supersized.
Hospitals are no exception. Around the country, medical facilities are buying equipment to accommodate the increase in obese patients.
In Milwaukee, several local hospitals have beefed up their beds, rooms and medical devices to accommodate larger patients.
The shift to the XXL-equipped hospital is eating into capital budgets and driving growth in the plus-sized medical equipment market.
From 1990 to 2006, the proportion of obese Wisconsin residents ballooned from 11.3% to 26.7%, according to a study from the Centers for Disease Control's Behavioral Risk Factor Surveillance System. That compares with 25.1% for the U.S. population as a whole. In Milwaukee, 28.6% of people were obese in 2004 to 2006, according to the report.
More than six in 10 hospitals around the country have seen an uptick in the number of morbidly obese patients, defined as those with a body mass index of more than 40, according to a June survey of hospitals by market research firm Novation.
Hospitals have stepped up efforts to support the heaviest patients in the last five to 10 years, said Terri Kendrick, director of purchasing for Wheaton Franciscan Healthcare. More than one in three hospitals have been renovated to account for obese patients or are planning to do so in the near future, according to the Novation study.
"There's definitely been an increase," Kendrick said. "We look at this with anything we purchase."
Boosting the basics
Obese, or bariatric, patients need everything from larger beds to stronger stretchers.
The Columbia St. Mary's Hospital at E. North Ave. and Lake Drive, due to open this fall, has roomier rooms and bigger doorways. Froedtert Hospital in Wauwatosa has retrofitted a couple of the 28 rooms on each floor for bariatric patients, said John Balzer, the system's vice president of facility planning and development.
The changes come in surprising places.
Hospitals used to mount toilets to the wall so that cleaners can mop the floor easily. But that poses problems for the heaviest patients.
"No one in their wildest dreams thought 10 to 15 years ago that patients would be in excess of 500, 600 pounds," Balzer said. "The toilets mounted to the wall won't accommodate those larger patients and will literally break off the wall."
Patients that large are now a fact of life. Froedtert is spending $300,000 this year to retrofit about 60 rooms with floor-mounted toilets and plans to spend about the same amount for several years to retool about 500 bathrooms in the hospital, Balzer said.
The plus-sized accommodations are paid for out of a fixed budget, Balzer said.
"Accommodating our patients is priority one, but it's unfortunate that to accommodate our patients we have to invest in something like toilets instead of some sort of new high-tech equipment," Balzer said.
Hospitals are adding wider, stronger wheelchairs that can support the heaviest patients. About 40% of the wheelchairs Wheaton Franciscan purchased from June 2008 to 2009 could accommodate patients who weighed 350 pounds or more. The following year, 76% of their wheelchair purchases were for the biggest patients, Kendrick said.
Bigger or adjustable beds also have been a hot item, as have stretchers and beds with motors that can assist nurses when they're maneuvering them, said Tim Pierret, a sales representative for the Stryker Medical patient care division, which sells stretchers, beds and other durable medical equipment.
"I have seen and heard a lot of customers requesting, 'Does your bed get " he wider? Are there any things that can accommodate larger patients?' said.
Even double-wide chairs are in high demand. Waiting rooms at Columbia St. Mary's Bariatric Center now have chairs that look like a loveseat but can handle someone who is 600 pounds, said Susan Dugan, the nurse coordinator at the hospital.
High-tech equipment has also gone plus-sized.
GE Healthcare sells a wide-bore MRI machine with a 70-centimeter diameter, rather than the standard 60-centimeter diameter. That's a boon to both claustrophobic patients and those with a bigger girth, said Chris Fitzpatrick, a global marketing manager for the wide-bore machines.
Three of the more spacious scanners are scheduled to be installed in Froedtert Hospital, a couple in the Aurora Health Care system, Fitzpatrick said. The group has also developed sitting MRI machines that can scan limbs without having to squeeze a patient's whole body through a small tunnel.
Larger patients require laparoscopic equipment with larger tubing, and special operating tables that can tip side-to-side or separate patients' legs to provide better viewing angles for cameras during surgery, Dugan said.
Columbia St. Mary's has also purchased lifts that mount to the ceiling and even inflatable "hover crafts" that nurses place under patients to transfer them from beds to stretchers or allow nurses to change the sheets under immobilized patients, she said.
The market for bariatric medical equipment has exploded over the past several years.
Millennium Research Group estimates that bariatric durable medical equipment is a billion-dollar industry in 2010. Kansas City, Mo.-based Sizewise had just a handful of employees 10 years ago and now employs more than 600, Westbrook said.
Bariatric equipment is often pricier than standard equipment.
Bariatric beds can be double the cost of a standard one, Pierret said. A standard, 18 inch-wide wheelchair costs anywhere from $150 at $330 at the Walgreen's website, but Sizewise's bariatric, motorized wheelchair, which can support a 1,000-pound person, costs roughly $1,500, Westbrook said.
The higher price tag is a result of higher manufacturing costs, including rigorous weight-loading tests, stronger joint welding and tougher, more durable raw materials, she said.
Despite the expense, spending on bariatric equipment is better for a hospital's bottom line than skimping on supplies, Dugan said. That's because nurses who try to maneuver obese patients without the proper tools get injured.
"Spending that money is less expensive than having staff get hurt," Dugan said.
61%: Percentage of hospitals that saw an increase in obese patients
36%: Percentage of hospitals that recently finished or are planning renovations to accommodate obese patients
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