Private and Public Bariatric Surgery Trends in New Zealand 2004-2017: Demographics, Cardiovascular Comorbidity and Procedure Selection.
Bariatric surgery
Cardiovascular comorbidity
Gastric bypass
New Zealand
Obesity
Sleeve gastrectomy
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
pubmed:
14
3
2020
medline:
15
4
2021
entrez:
14
3
2020
Statut:
ppublish
Résumé
For bariatric surgery, patient selection, procedural choice and availability has changed over time internationally. We analysed the annual volume and location of bariatric surgery in New Zealand by demographic characteristics, clinical history and procedure. Patients who underwent bariatric procedures between 1 January 2004 and 31 December 2017 were identified through New Zealand hospitalisation records. Hospitalisation and medication data were used to indicate a clinical history of cardiovascular disease (CVD) and/or diabetes. Publicly funded intervention rate by ethnicity was calculated using year- and sex-specific ethnic population estimates and obesity prevalence statistics. This study included 9109 patients, undergoing gastric bypass (GB, n = 3323) and sleeve gastrectomy (SG, n = 5452) as the most common procedures. Nationally, annual bariatric surgery volume increased in the public sector, from 34 to 516 between 2004 and 2017, with a similar increase in available private sector figures. Public recipients were significantly more likely to have a history of diabetes (33.8% vs 14.4%) and/or CVD (9.0% vs 4.7%) than private recipients. Male recipients had higher prevalence of diabetes (29.9% vs 17.6%) and CVD (12.9% vs 4.1%) than female recipients. After adjustment for the adult population prevalence of morbid obesity, Pacific people had half the intervention rate of European and Māori. Bariatric surgery is increasing in frequency in New Zealand, with SG and GB being the most common procedures. Significant differences in patient characteristics exist between the public and private sectors. Ensuring equitable selection of publicly funded bariatric surgery candidates remains a challenge.
Sections du résumé
BACKGROUND
For bariatric surgery, patient selection, procedural choice and availability has changed over time internationally. We analysed the annual volume and location of bariatric surgery in New Zealand by demographic characteristics, clinical history and procedure.
METHODS
Patients who underwent bariatric procedures between 1 January 2004 and 31 December 2017 were identified through New Zealand hospitalisation records. Hospitalisation and medication data were used to indicate a clinical history of cardiovascular disease (CVD) and/or diabetes. Publicly funded intervention rate by ethnicity was calculated using year- and sex-specific ethnic population estimates and obesity prevalence statistics.
RESULTS
This study included 9109 patients, undergoing gastric bypass (GB, n = 3323) and sleeve gastrectomy (SG, n = 5452) as the most common procedures. Nationally, annual bariatric surgery volume increased in the public sector, from 34 to 516 between 2004 and 2017, with a similar increase in available private sector figures. Public recipients were significantly more likely to have a history of diabetes (33.8% vs 14.4%) and/or CVD (9.0% vs 4.7%) than private recipients. Male recipients had higher prevalence of diabetes (29.9% vs 17.6%) and CVD (12.9% vs 4.1%) than female recipients. After adjustment for the adult population prevalence of morbid obesity, Pacific people had half the intervention rate of European and Māori.
CONCLUSION
Bariatric surgery is increasing in frequency in New Zealand, with SG and GB being the most common procedures. Significant differences in patient characteristics exist between the public and private sectors. Ensuring equitable selection of publicly funded bariatric surgery candidates remains a challenge.
Identifiants
pubmed: 32166697
doi: 10.1007/s11695-020-04463-x
pii: 10.1007/s11695-020-04463-x
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2285-2293Références
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