Quantitative analysis of bariatric procedure trends 2001–13 in South Australia: implications for equity in access and public healthcare expenditure
Samantha B. Meyer A F , Sue Booth B , John Gray C , Paul Hakendorf D , Darlene McNaughton B , Lillian Mwanri B , Campbell Thompson E and Paul R. Ward BA University of Waterloo, 200 University Ave, Waterloo, Ontario, N2L3G1, Canada.
B Flinders University, Sturt Road, Bedford Park, SA 5042, Australia. Email: sue.booth@flinders.edu.au; darlene.mcnaughton@flinders.edu.au; lillian.mwanri@flinders.edu.au; paul.ward@flinders.edu.au
C South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia. Email: john.gray@sahmri.com
D Flinders Medical Centre and Flinders University, Sturt Road, Bedford Park, SA 5042, Australia. Email: Paul.Hakendorf@health.sa.gov.au
E University of Adelaide, SA 5000, Australia. Email: Campbell.thompson@adelaide.edu.au
F Corresponding author. Email: samantha.meyer@uwaterloo.ca
Australian Health Review 39(1) 63-69 https://doi.org/10.1071/AH14140
Submitted: 9 July 2014 Accepted: 16 September 2014 Published: 13 November 2014
Journal Compilation © AHHA 2015
Abstract
Objectives The aims of the present study were to: (1) identify trends in bariatric surgery in South Australia (SA) from 2001 to 2013; and (2) compare public and private hospitals, and so discuss the implications of these trends as they relate to equity in access to bariatric procedures and public system healthcare expenditure.
Methods An analysis of retrospective data of all bariatric procedures in public and private hospitals in SA was conducted using all SA public and private hospital administrative records between 2001 and 2013.
Results Of all procedures conducted in SA, 22.6% were revisions or reversals. The number of revisions or reversals conducted in SA has increased at a rate higher than weight loss procedures (6.4- vs 3.8-fold increase). An increasing proportion of public surgeries are revisions or reversals of weight loss procedures that occurred outside of the SA public system (interstate or in the private system).
Conclusion Further investigation is necessary to identify the pathways patients navigate to access bariatric surgery, the utilisation of public services following private procedures and why rates of revisions or reversals of bariatric procedures are increasing in SA.
What is known about the topic? Rates of bariatric surgery are increasing internationally as a treatment for obesity.
What does this paper add? Trends in bariatric procedures in SA have not been published. We have identified that: (1) rates of bariatric revisions or reversals in SA far surpass the rate at which bariatric weight loss procedures are increasing; (2) rates of revisions or reversals are increasing in public hospitals; and (3) an increasing number of the revision or reversal procedures in public hospitals are for weight loss procedures that have occurred outside the public system.
What are the implications for practitioners? The data have implications for practitioners caring for patients interested in undergoing bariatric surgery for the treatment of obesity. The data suggest that rates of revisions or reversals are increasing in public hospitals, which suggests that further information is needed regarding the effectiveness of weight loss procedures and the implications of revision or reversal increases on waiting times for patients seeking weight loss treatment in a system with limited resources.
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