Attrition after acceptance onto a publicly funded bariatric surgery program

Making Education Easy

Authors:

Taylor T et al.

September 25, 2018

Summary:

These researchers retrospectively analysed data from 704 New Zealanders referred for and accepted onto a publicly funded bariatric surgery from 2007 to 2016. A total of 326 completed surgery successfully; 378 left the progamme before surgery, corresponding to an attrition rate of 54%. Attrition differed significantly by gender (men 66% vs 45% women; p<0.001) and ethnicity (39% in NZ Europeans, 50% in Māori, and 73% in Pacific patients; p<0.001). Whereas 2 out of 3 European women proceeded to surgery, compared with <1 in 7 Pacific men. Attrition was associated with having a higher mean BMI and being a smoker. Logistic regression analysis revealed a protective effect of employment against attrition for NZ Europeans (p<0.004), which was not apparent among Pacific patients.

Comment:

The pathway into and through bariatric surgery is complex. As these studies suggest, the response of the health systems is affected by wider societal values, including the way society portrays and treats people of various genders, ethnicities, BMIs and work situations. I was a little disappointed to see the recommendation in the second paper for research on a person’s culture, as a potential barrier, when there was little evidence to suggest that this was an issue. Perhaps a focus on the culture of our society, and how we view bariatric surgery, is warranted.

Reference: Obes Surg. 2018;28(8):2500-7

Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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