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PubMed1999

The influence of health needs assessment on health care decision-making in London health authorities.

OBJECTIVES: Health needs assessment gained prominence under the model of health care purchasing developed to support the 1991 reforms of the UK National Health Service (NHS). The objectives of this paper are to determine how needs assessment has been used in the NHS, to assess the influence it has had on decision-making, and to relate the observed uses of needs assessment to competing theoretical models of health care policy-making. METHODS: A survey of needs assessment activity in 14 London health authorities identified 217 needs assessments conducted between 1993 and 1996. Semi-structured interviews were conducted with public health and commissioning staff in each authority. RESULTS: The survey indicated that needs assessment directly supported decision-making and action in two-thirds of the studies identified, but up to 20% of needs assessments had no impact on service provision. Four key functions of health needs assessment were observed: identifying a problem; planning detailed changes to services; providing post hoc justification for earlier decisions; and using participation in needs assessment to build 'ownership' of subsequent decisions. CONCLUSIONS: The survey suggests that needs assessment is, in practice, consistent with a 'mixed scanning' model of decision-making. Needs assessment is used to help select issues for detailed investigation and to direct analytical and decision-making resources. However, certain key areas are not amenable to technical analysis and solution, and are resolved through bargaining.

Data Collection↗
PubMed2000

Service needs of parents with motor or multiply disabled children in Dutch therapeutic toddler classes.

OBJECTIVE: To determine parents' service needs at the start of therapeutic toddler class treatment, to analyse determinants and to investigate received help after a period of 10 months. SUBJECTS: Parents with motor or multiply disabled children in therapeutic toddler classes. SETTING: Sixteen out of 17 Dutch rehabilitation centres. DESIGN: A sample of 84 parents, stratified according to toddler class size. MAIN OUTCOME MEASURES: A questionnaire of 33 items, divided into five categories, was designed to assess parents' needs and to evaluate the amount of received help. Several measures were used to assess child, parent and family characteristics. RESULTS: Based on factor analysis, five need subscales were distinguished which only partially corresponded to the initial categories. The initial category concerning needs for help in family functioning did not come out as a factor. Needs expressed most frequently belonged to the three subscales of needs for information concerning the child. The average level of needs generally did not differ for mothers and fathers across the subscales. However, we found large variation in needs for both mothers and fathers on each subscale. The most important, positively correlated determinant of parents' needs was social isolation of the family. After 10 months a considerable level of unmet needs was found. CONCLUSIONS: A systematic and periodic assessment of individual needs of parents as well as the services offered is recommended. Professionals of the therapeutic toddler classes should especially focus on providing parents with information on their child's disability and therapy, community services and parenting.

Adult↗
PubMed1997

Unmet long-term care needs of elderly people in the community: a review of the literature.

The extent of unmet need, or the extent to which needed assistance is unavailable for insufficient, is an important issue in public policy and financing of health and support services. This article reviews the research of literature to assess how unmet method is measured, and the extent of unmet needs among elderly people in the community. Measurement difficulties include variable definitions and measures of need across studies, the relative dearth of studies which undertake to measure unmet needs, and varying methodologies used to estimate need and unmet need. In addition, some measures of status and need, such as cognitive impairment and care giver burden are excluded from many estimates. Estimates of unmet need range from around 2 percent to about 35 percent of community dwelling elders, depending on what is included or excluded from the definition. Unmet need is associated with higher disability levels and living alone. The literature suggests that estimates of future unmet need will be mitigated by declining disability levels and increased use of assistive devices among the elder population.

Activities of Daily Living↗
PubMed2003

Unmet need and unintended fertility: longitudinal evidence from upper Egypt.

CONTEXT: Although unmet need for family planning is a standard measure for evaluating programs' effectiveness in meeting the reproductive needs of individuals, its validity and accuracy in identifying women most at risk of unintended pregnancy have been questioned. METHODS: Women who participated in the 1995 Egypt Demographic and Health Survey in two governorates in Upper Egypt (Assuit and Souhag) were followed for two years (N=2,444); in-depth data on their fertility preferences, contraceptive use and births were gathered in 1996 and 1997. Transitions among contraceptive need categories from 1995 to 1997 are examined, and rates of unintended (mistimed and unwanted) births are calculated according to contraceptive need status at baseline. RESULTS: In the aggregate, unmet need increased by six percentage points, from 28% to 34%. This change was the net outcome of 14% moving out of unmet need and 20% moving into unmet need (i.e., substantial satisfaction of unmet need was offset by increased demand for contraception). The rate of unintended fertility was far higher among women with unmet need at baseline than among contraceptive users in 1995. Women with unmet need made up about one-quarter of the baseline sample, but they contributed almost one-half of mistimed and unwanted births during the two years. The majority of unintended births were to women who had never practiced contraception, whereas fewer than one-fifth were to women with recent contraceptive experience (including contraceptive failure). CONCLUSIONS: : Unmet need for family planning remains a useful tool for identifying and targeting women at high risk of unintended pregnancy.

Contraceptive Agents↗
PubMedDate not supplied

A study of the needs of parents of hospitalized 2- to 6-year-old children.

The present study uses a qualitative approach to explore and identify areas of needs among parents of 2- to 6-year-old children who are hospitalized. An extensive literature review and informal in-depth interviews with five parents and six pediatric health care professionals were analyzed by content to develop a representative list of statements about needs. Six groups of needs were recognized: (a) the need to be able to trust doctors and nurses, (b) the need for information, (c) needs related to other family members, (d) a need to feel that they are trusted, (e) needs related to human and physical resources, and (e) the need for support and guidance. A congruency is found between statements about needs of parents of hospitalized 2- to 6-year-olds in the literature on the one hand and the needs of parents expressed by parents themselves and pediatric health care professionals on the other hand.

Child↗
PubMed1986

Is counting the dead enough? Strategies for monitoring health needs in New York City.

Determining health care needs--especially unmet needs--in New York City should continue as a research and policy priority, especially in a rapidly changing health care environment. Among the many data sources that can be used in assessing needs are: mortality data; census data; other vital statistics; National Health Interview Survey data; other interview and survey data; physician examination of patients. Among the uses to which these and other data are being put in an effort to determine unmet need and health status are: predicting age-sex-specific demographic, health status, and utilization trends; analysis of sentinel health events; developing hierarchies of need for small areas; development of city and neighborhood "health profiles"; provider determination of needs for program planning. Obstacles to progress persist, however, including the increasing costs of data gathering and analysis; lack of popular or political support for needs assessment; and problems in defining what health care needs are. Among high priorities for those interested in better assessment of health care needs in New York City are: recreating public and political interest in the issue; garnering more financial support for research; countering trends toward privatization and fragmentation of data collection and analysis efforts; new relationships between academic and other researchers; better definition of need and refinement of research methodologies and data bases; development of a clear strategy for assessing health needs in New York City in the future, and garnering broad support for implementing it.

Data Collection↗
PubMed2000

Needs assessment in primary care: general practitioners' perceptions and implications for the future.

BACKGROUND: Health needs assessment can guide the appropriate shift to primary care by identifying the most effective and efficient resource allocation to meet the needs of populations. Assessing health care needs will be a continuing challenge for primary care trusts in Scotland (or equivalent groups in other parts of the United Kingdom); however, lessons must be learned from the experience of needs assessment that followed the 'internal market' reforms of the 1990s. AIM: To examine general practitioners' (GPs') awareness and experience of needs assessment, to identify barriers to needs assessment in primary care, and to ascertain how better progress might be made in the future. METHOD: A postal questionnaire survey of 1777 Scottish GPs (a one-in-two sample) was combined with a semistructured interview survey of 'lead' GPs from a random sample of 64 mainland Scottish practices between May and August 1996. RESULTS: Sixty-five per cent (1154) of GPs responded to the questionnaire, of which 54% (965) were completed. Over 73% (47) of interviews were completed. Most GPs were unfamiliar with the concept of needs assessment and there was no evidence that needs assessment had influenced commissioning decisions. Most GPs argued that it was not a 'core' activity and that they lacked training in the relevant skills. While the attitude of the majority was indifferent, cynical, and sometimes hostile, a minority, comprising mostly younger fundholders, was more enthusiastic about needs assessment. CONCLUSION: The motivation and attitude of the majority of GPs present a barrier to needs assessment in primary care. GPs will require more resources and training if they are to undertake this responsibility. Most GPs believe than incentives (financial or organisational) will be necessary. Primary care trusts and equivalent structures should be aware of these attitudes as they seek to establish plans based on estimates of population needs in defined locations.

Adult↗
PubMed2000

The unmet health needs of America's children.

OBJECTIVE: Unmet need for health care is a critical indicator of access problems. Among children, unmet need for care has special significance inasmuch as the failure to obtain treatment can affect health status and functioning in the near- and long-term. The purpose of this study was to present current prevalence estimates and descriptive characteristics of children with unmet health needs using nationally representative household survey data. METHODS: We analyzed 4 years of National Health Interview Survey data spanning 1993 through 1996. Our analysis included 97 206 children <18 years old. Measures of unmet need for medical care, dental care, prescription medications, and vision care were obtained from an adult household member (usually the mother) responding for the child. Bivariate and multivariate analyses were used to assess the degree to which unmet need was related to the demographic and socioeconomic characteristics of the child and family. RESULTS: Overall, 7.3% (4.7 million) of US children experienced at least 1 unmet health care need. Dental care was the most prevalent unmet need. After adjustment for confounding factors, near-poor and poor children were both about 3 times more likely to have an unmet need as nonpoor children (adjusted odds ratio [95% confidence interval] = 2.89 [2.52, 3.32], 3.0 [2.53, 3.56], respectively). Uninsured children were also about 3 times more likely to have an unmet need as privately insured children (adjusted odds ratio [95% confidence interval] = 2. 92 [2.58, 3.32]). CONCLUSIONS: Despite the nation's great wealth, unmet health needs remain prevalent among US children. A combined public policy that addresses financial and nonfinancial barriers to care is required to reduce the prevalence of unmet need for health care.

Adolescent↗
PubMed2000

A longitudinal study of orthodontic treatment need in Dunedin schoolchildren.

The Index of Orthodontic Treatment Need (IOTN) was used to assess unmet orthodontic treatment need in 152 13-year-old Dunedin schoolchildren, and to compare the findings with those obtained in the same children 3 years previously. The children were randomly selected from Dunedin schools as 10-year-olds, and had not received orthodontic treatment. Approximately 86 percent of the 13-year-old children had "No-little" need for orthodontic treatment when assessed by the child-assessed Aesthetic Component (AC) and the examiner-assessed AC. Slightly less than half the children had "No-little" need for orthodontic treatment when assessed with the Dental Health Component (DHC). More 10- and 13-year-old children "Needed" orthodontic treatment with the DHC than with the AC. Both the examiner-assessed AC and the DHC assessed significantly fewer 13-year-olds as needing orthodontic treatment than the same children as 10-year-olds. Complete agreement between the grades assigned at 10 and 13 years occurred in 30-43 percent of the children and, in the treatment-need categories, between 53 percent (DHC) and 84 percent (child-assessed AC) of the children. The fall in treatment need over the 3-year period may be due to selection bias, over-sensitivity of the IOTN to mixed dentition traits, or both. Although a number of 10-year-old children were assigned different grades as 13-year-olds, many remained within the same treatment category. The apparent stability of the IOTN to assess treatment need in 10- and 13-year-old children is attributed to the grouping of different occlusal traits in the same treatment-need category, and to the small number of treatment-need categories in each component.

Adolescent↗
PubMed2000

An examination of the role of clinical psychology in meeting the needs of young disabled clients and their families/carers.

This paper examines the views of clients with a physical disability, general practitioners and staff working in health and social work physical disability services about the needs of young disabled people. The most common area of disability seen by GPs was respiratory, followed by cardiac problems and stroke. With the exception of cardiac patients a third to over half of GPs felt that the needs of the identified groups were not being adequately met, in particular the needs of individuals with progressive neuromuscular problems. Over a quarter of clients felt that their needs were not being adequately met. Ninety-five percent of GPs and 100% of staff identified psychological needs of clients. For clients themselves, physical needs are ranked highest, with over 33 percent identifying psychological problems, 50 percent neuropsychological problems and 25 percent psychosexual difficulties as priority needs. In relation to carers, over 90 percent of GPs, 100% of staff and 50 percent of clients highlighted psychological needs. The majority of participants felt that clinical psychology had an important role to play in physical disability services. There was broad agreement on the areas of need which psychology would be seen to address. These were psychological needs, behavioural problems, neuropsychological problems and relationship/psychosexual difficulties. A high percentage of both staff and GPs also saw a role for clinical psychology in meeting the psychological, relationship and psychosexual needs of carers.

Attitude of Health Personnel↗
PubMed1986

[Handicaps and needs of the elderly. A multifactor epidemiologic study under urban conditions].

As the number of old people increases, the need for a reliable statistical basis for socio-medical planning becomes more and more evident. Results of a representative survey in two cities of German-speaking Switzerland are presented, including correlations between the extent of need for assistance and predisposing factors. About half of the elderly are not disabled in everyday life, but 9.3% of the 66- to 75-year-olds and 46.1% of the over 85-year-olds are in need of regular daily assistance. In addition to age, male sex and being unmarried turned out to be independent predisposing factors for an increased need for help. Women were in the majority in some particular disturbances, but as a whole their need for assistance was less than among men. Socio-economic status was the most important risk factor for need for assistance. In comparison to those from higher social classes, elderly from the lowest class are round five times as often in nursing homes and ten times as often in residential homes. Their need for all forms of assistance is increased, and, in particular, they need much more daily household help than those in higher socio-economic groups. The number of admissions to institutions could be considerably reduced if more of these elderly persons could be offered ambulatory household assistance services. Furthermore, elderly of low socio-economic status tend to live more in unsuitable dwellings, eat food of lower quality, get less physical exercise, are less often of normal body weight, and have functional disturbances more often. Among the predominant factors associated with the need for nursing care are disturbances of orientation, incontinence and visual disturbances, whereas cardiovascular diseases and malignant tumors are of little importance in this context. The situation is different with respect to the need for household help, which is particularly frequent among persons with disturbances of the extremities. These in turn are about twice as frequent among elderly of lower social class than among those who are better-off. In the population under study about 40% of the elderly requiring daily nursing assistance are cared for in their homes, with their own family members providing most of the assistance. This is less often the case in the lower socio-economic groups. Our analyses make it possible, for the first time in Switzerland at least, to demonstrate clearly the important role social status, family situation and gender play in determining the level of disability and need for assistance among the elderly.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1982

The concept of need in dental care.

The most commonly used methods of assessing need for treatment are based solely on clinical criteria. Recently, it has been recognized that a wider interpretation than that provided by clinically assessed need is required. Measures of need should include the impact of ill health upon individuals, the degrees of dysfunction and the perceptions and attitudes of patients. Although there is no generally agreed definition of need, the taxonomy suggested by Bradshaw (1972) is recommended. He divides need into normative, felt, expressed and comparative types. One of the major shortcomings of all methods of assessing need is that they do not assess the need and propensity for preventive care and health education. A more realistic assessment of treatment needs should include the functional and social dimensions of dental disease and an assessment of the social and motivational factors which predispose people towards dental ill health and influence the effectiveness of treatment and health education. Some dental needs are not very well assessed. In particular, the assessment of the need for treatment of malocclusion, whilst claiming to be objective, does not incorporate measures of lay perception or impact of the condition. Instead of relying only upon purely clinical methods of assessing needs, the development of sociodental indicators is required. This will encourage a shift in emphasis away from the mechanical to the behavioural aspects of treatment and the development of a health-orientated model of care in preference to the sickness model that dominates current dental services.

Dental Care↗
PubMed1996

Community service needs of people with HIV infection in London.

The objectives of this study were to describe the expressed needs for community services of HIV-infected individuals by disease stage, gender and transmission category and the barriers which prevent the receipt of such services. Structured interviewer-administered questionnaires concerning a 6-month retrospective period were used to obtain information on need for community services and problems which prevented the receipt of services. The study sample included 70 homosexual men with asymptomatic HIV disease, 42 homosexual men with symptomatic non-AIDS, 53 homosexual men with AIDS, 23 heterosexual men, 29 heterosexual women, 9 male and 9 female injecting drug users. The main outcome measures were the extent to which needs for community services were met and person/service combinations for which problems or barriers prevented the receipt of community services. On average, subjects expressed a need for 10 categories of community services over the 6-month period: homosexuals expressed a mean of 10, heterosexuals 10, injecting drug users 11, subjects with asymptomatic HIV infection 9, subjects with symptomatic non-AIDS 11, subjects with AIDS 13, men 9 and women 14. A total of 58% of community service needs were always met, 6% were rarely not met, 16% were sometimes not met, 6% were often not met and 14% were not met at all. The extent to which subjects felt that their needs were met was similar for the different study groups, but the needs of women were met somewhat less frequently than those of men. Similarly, people with AIDS felt that their needs were met slightly less often. Reported levels of unmet need were high for a wide range of services. The most common reason subjects gave for not having received a community service for which they expressed a need was ignorance of where or how to obtain the service. This was mentioned in one-third of all such cases. Anxieties over the competence with which a service would be rendered was mentioned in 13% of cases and long waiting times in 11%. The frequencies of unmet need for many community services were high and often seemed to arise either from a lack of awareness on the part of subjects on how and where services could be obtained or from doubts about the relevance of services offered. Both of these barriers should be surmountable through the provision of better information to patients, extending user involvement in service development and the better co-ordination of service delivery through care management approaches.

Adult↗
PubMed2002

The unmet needs of young people who have had a stroke: results of a national UK survey.

BACKGROUND: Most stroke-related studies have consisted of people over the age of 65. This study examined the unmet needs of young people with stroke, living in community housing in the UK. METHOD: People with a stroke (>1 year ago), in two age bands (18-45; 46-65) were sent the Southampton Needs Assessment Questionnaire for people with Stroke. RESULTS: 315 out of 639 (49%) questionnaires were returned (mean age 55, SD 9; 189 males, 126 females). The median number of unmet needs reported was two (IQR 0-6). The most frequently reported unmet needs were: provision of information about the responders' stroke (45%); assistance with finances (24%); non-care activities (19%); and intellectual fulfillment (17%). Responders in the younger age group reported significantly more unmet needs than responders in the older age group (for a holiday, intellectual fulfillment and family support). Responders with poor mobility reported significantly more unmet needs than responders with average and good mobility for 15 unmet needs (three most pressing: respite care/short breaks; adaptations; and access to community environment). Responders who did not return to work reported significantly more unmet needs than responders who had reduced hours or changed jobs and people who returned to the same job with the same hours for seven unmet needs (three most pressing: help with finances; a holiday and speech therapy). CONCLUSION: People of younger age, with poorer mobility and those unable to return to work, report most unmet needs. Further work needs to be done within the community, with employers and professionals, in relation to education and the provision of specifically targeted information in order to facilitate participation and autonomy for people with stroke.

Adolescent↗
PubMed1995

Pilot study comparing parents' and third-grade schoolchildren's attitudes toward braces and perceived need for braces.

An instrument developed for third-grade schoolchildren and their parents was pilot-tested for its ability to measure orthodontic attitudes and perception of the child's need for braces. Seventy-eight children and 54 parents were surveyed. Forty-six percent of the children wanted braces while 61% believed that they needed braces. Correlation between desire for braces and perceived need was 0.47, suggesting that desire and perceived need were only moderately correlated in children. Sixty-three percent of the parents believed that their child needed braces. Despite such proportions of children and parents perceiving a need for treatment, three-fourths of the children and two-thirds of the parents were satisfied with the appearance of the child's teeth. Attitude subscales, derived from the attitude survey, and clinical orthodontic parameters were used to model children's and parents' perceived need for braces in the child. No clinical parameter was a significant correlate in either children's or parents' model of perceived need. Neither race nor gender contributed significantly to either model. The subscales Concern for Appearance and Social Aspects of Braces were the strongest covariates of children's perceived need for braces. Concern for Appearance was the most important correlate in the parents' model. These data suggest that parents' perceived need for orthodontic treatment for their third-grade children is determined primarily by a concern for appearance rather than clinical status. In third-graders, perceived aesthetics and social aspects apparently have more influence than clinical status in creating a perception of need for braces.

Attitude to Health↗
PubMed2006

Uncorrected refractive errors and spectacle utilisation rate in Tehran: the unmet need.

AIM: To determine the prevalence of the met and unmet need for spectacles and their associated factors in the population of Tehran. METHODS: 6497 Tehran citizens were enrolled through random cluster sampling and were invited to a clinic for an interview and ophthalmic examination. 4354 (70.3%) participated in the survey, and refraction measurement results of 4353 people aged 5 years and over are presented. The unmet need for spectacles was defined as the proportion of people who did not use spectacles despite a correctable visual acuity of worse than 20/40 in the better eye. RESULTS: The need for spectacles in the studied population, standardised for age and sex, was 14.1% (95% confidence interval (CI), 12.8% to 15.4%). This need was met with appropriate spectacles in 416 people (9.3% of the total sample), while it was unmet in 230 people, representing 4.8% of the total sample population (95% CI, 4.1% to 5.4%). The spectacle coverage rate (met need/(met need + unmet need)) was 66.0%. Multivariate logistic regression showed that variables of age, education, and type of refractive error were associated with lack of spectacle correction. There was an increase in the unmet need with older age, lesser education, and myopia. CONCLUSION: This survey determined the met and unmet need for spectacles in a Tehran population. It also identified high risk groups with uncorrected refractive errors to guide intervention programmes for the society. While the study showed the unmet need for spectacles and its determinants, more extensive studies towards the causes of unmet need are recommended.

Adolescent↗
PubMed1998

Number needed to screen: development of a statistic for disease screening.

OBJECTIVES: To develop the number needed to screen, a new statistic to overcome inappropriate national strategies for disease screening. Number needed to screen is defined as the number of people that need to be screened for a given duration to prevent one death or adverse event. DESIGN: Number needed to screen was calculated from clinical trials that directly measured the effect of a screening strategy. From clinical trials that measured treatment benefit, the number needed to screen was estimated as the number needed to treat from the trial divided by the prevalence of heretofore unrecognised or untreated disease. Directly calculated values were then compared with estimate number needed to screen values. SUBJECTS: Standard literature review. RESULTS: For prevention of total mortality the most effective screening test was a lipid profile. The estimated number needed to screen for dyslipidaemia (low density lipoprotein cholesterol concentration >4.14 mmol/1) was 418 if detection was followed by pravastatin treatment for 5 years. This indicates that one death in 5 years could be prevented by screening 418 people. The estimated number needed to screen for hypertension was between 274 and 1307 for 5 years (for 10 mm Hg and 6 mm Hg diastolic blood pressure reduction respectively) if detection was followed by treatment based on a diuretic. Screening with haemoccult testing and mammography significantly decreased cancer specific, but not total, mortality. The number needed to screen for haemoccult screening to prevent a death from colon cancer was 1374 for 5 years, and the number needed to screen for mammography to prevent a death from breast cancer was 2451 for 5 years for women aged 50-59. CONCLUSION: These data allow the clinician to prioritise screening strategies. Of the screening strategies evaluated, screening for, and treatment of, dyslipidaemia and hypertension seem to produce the largest clinical benefit.

Adult↗
PubMed2004

Determinants of the need for intensive care and prolonged mechanical ventilation in patients undergoing bariatric surgery.

BACKGROUND: Bariatric surgery at the upper extremes of weight can be associated with serious postoperative complications. In many cases, these complications will require the availability of critical care resources. The purpose of this study is to examine factors that increase the likelihood for prolonged postoperative intensive care unit (ICU) and extended mechanical ventilation (MV) >24 hours. METHODS: A retrospective chart review was conducted of all patients undergoing bariatric surgery over a 7-year period at a tertiary care academic institution. There were 250 total patients undergoing either vertical banded gastroplasty (n=15) or Roux-en-Y gastric bypass (n=235). Age, Gender, BMI, pulmonary co-morbidity, revisional surgery (previous bariatric operations), and need for reoperation for suspected intra-abdominal complications were examined by univariate and multivariate analyses. RESULTS: Mean age was 43.6+/-10.6 years and mean BMI 56+/-10.6 kg/m2. Pulmonary co-morbidity was present in 123/250 patients (49%), 42/250 (17%) had revisional surgery, and 21/250 (8%) required reoperation. ICU care was required in 60 patients (24%). By univariate analysis, age >50 yrs (P=0.047), male gender (P=0.038), and need for reoperation (P <0.001) were associated with need for ICU. By multivariate analysis, BMI >60 kg/m2, odds ratio (OR) 2.25, 95% confidence Interval (CI) 1.11-4.60, P=0.04, and need for reoperation, OR 39.8, 95% CI 10.41-264.7, P <0.0001, were associated with need for ICU. MV >24 hrs was required in 44 patients (18%). By univariate analysis, BMI >60 kg/m2 (P=0.013), pulmonary co-morbidity (P=0.014), male gender (P =0.029), and reoperation (P <0.0001) were associated with need for MV. By multivariate analysis, BMI >60 kg/m2, OR 3.1, 95% CI 1.44-7.13, P=0.005, and need for reoperation, OR 22.3, 95% CI 7.4-79.2, P <0.0001, were associated with need for MV. CONCLUSIONS: Patients who are male, older (>50 yrs), heavier (BMI >60 kg/m2), and who have complications requiring reoperation will likely need intensive care. Additionally, males, heavier patients (BMI >60 kg/m2), pulmonary co-morbidity, and need for reoperation may warrant need for extended MV. Surgeons and hospitals should consider this when planning resources for bariatric surgery programs.

Adolescent↗