Provision and outcomes of publicly funded bariatric surgery in a metropolitan versus a provincial population of New Zealand

IF 1.5 4区医学 Q3 SURGERY

ANZ Journal of Surgery Pub Date : 2024-10-01 DOI:10.1111/ans.19206

Henry Witcomb Cahill MbChB, MHSc, Matthew McGuinness MBChB, MHSc, Jamie Struthers MBChB, Ian Bissett MBChB, MD, BSC, FRACS, Christopher Harmston MBChB, FRACS (GS)

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Abstract

Background

Obesity is an important health problem worldwide. The prevalence of obesity in Aotearoa New Zealand (AoNZ) is the third highest amongst OECD countries. Previous studies have demonstrated inequity in the provision of bariatric and metabolic surgery (BMS) across AoNZ, but detailed data regarding patients and surgical outcomes is lacking. The aim of this study is to examine the rates and outcomes of BMS between patients domiciled in a metropolitan versus provincial area in AoNZ.

Methods

A 5-year retrospective observational cohort study of all patients who received BMS domiciled in a metropolitan or a provincial area in the Northern region of AoNZ was performed. Interrogation of patient electronic medical records and clinical notes was performed to collect the required baseline characteristics, secondary outcome measure data and confirm domicile.

Results

The rate of BMS was 6.1 times higher in the population with class III obesity domiciled in the metropolitan versus the provincial population. Patients in the metropolitan area were less obese, had lower rates of diabetes and had a wider range of procedures performed. Māori were underrepresented in both cohorts. There was a higher resolution of diabetes in the provincial patients.

Conclusion

This study has highlighted significant differences in the rate, type and outcomes of BMS between a metropolitan and provincial area in the Northern region of AoNZ. This represents a significant health inequity. Changes in national and regional policies are needed to ensure equitable care for patients with obesity in AoNZ.

Abstract Image

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新西兰大都市与外省人口中公费减肥手术的提供情况和结果。

背景：肥胖症是全球范围内的一个重要健康问题。新西兰奥特亚罗瓦的肥胖症发病率在经合组织国家中排名第三。以往的研究表明，新西兰各地在提供减肥和代谢手术（BMS）方面存在不公平现象，但缺乏有关患者和手术结果的详细数据。本研究旨在探讨澳新地区大都市与省级地区患者之间的肥胖代谢手术率和手术效果：对居住在澳新北部地区大都市或省级地区的所有接受 BMS 的患者进行了为期 5 年的回顾性队列观察研究。研究人员询问了患者的电子病历和临床笔记，以收集所需的基线特征、次要结果测量数据并确认住所：结果：居住在大城市的 III 级肥胖症患者的 BMS 患病率是居住在外省的患者的 6.1 倍。大城市地区的患者肥胖程度较轻，糖尿病发病率较低，接受手术的范围较广。两个群体中毛利人的比例都较低。外省患者的糖尿病发病率较高：这项研究强调了新西兰北部地区大都市和省级地区之间在BMS的比率、类型和结果方面的显著差异。这代表着严重的健康不公平。需要改变国家和地区政策，以确保为澳新肥胖症患者提供公平的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ANZ Journal of Surgery 医学-外科

CiteScore

2.50

自引率

11.80%

发文量

720

审稿时长

2 months

期刊介绍： ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.