Department of Medicine, 2F1,26 Walter C, Mackenzie Health Sciences Centre, University of Alberta, 8440-112th Street, Edmonton, T6G 2B7, Alberta, Canada.
Int J Equity Health. 2012 Sep 18;11:54. doi: 10.1186/1475-9276-11-54.
Bariatric surgery is the most effective current treatment for severe obesity. Capacity to perform surgery within Canada's public health system is limited and potential candidates face protracted wait times. A better understanding of the gaps between demand for surgery and the capacity to provide it is required. The purpose of this study was to quantify and characterize the bariatric surgery-eligible population in Canada in comparison to surgery-ineligible subjects and surgical recipients.
Data from adult (age > 20) respondents of the 2007-09 nationally representative Canadian Health Measures Survey (CHMS) were analyzed to estimate the prevalence and characteristics of the surgery-eligible and ineligible populations. Federally mandated administrative healthcare data (2007-08) were used to characterize surgical recipients.
In 2007-09, an estimated 1.5 million obese Canadian adults met eligibility criteria for bariatric surgery. 19.2 million were surgery-ineligible (3.4 million obese and 15.8 million non-obese). Surgery-eligible Canadians had a mean BMI of 40.1 kg/m2 (95% CI 39.3 to 40.9 kg/m2) and, compared to the surgery-ineligible obese population, were more likely to be female (62 vs. 44%), 40-59 years old (55 vs. 48%), less educated (43 vs. 35%), in the lowest socioeconomic tertile (41 vs. 34%), and inactive (73 vs. 59%). Self-rated mental health and quality of life were lower and comorbidity was higher in surgery-eligible respondents compared with the ineligible populations. The annual proportion of Canadians eligible for surgery that actually underwent a publicly funded bariatric surgery between 2007-09 was 0.1%. Surgical recipients (n = 847) had a mean age of 43.6 years (SD 11.1) and 82% were female. With the exception of type 2 diabetes, obesity-related comorbidity prevalence was much lower in surgical recipients compared to those eligible for surgery.
The proportion of bariatric surgery-eligible Canadians that undergo publicly funded bariatric surgery is very low. There are notable differences in sociodemographic profiles and prevalence of comorbidities between surgery-eligible subjects and surgical recipients.
减重手术是目前治疗重度肥胖最有效的方法。加拿大公共卫生系统的手术能力有限，潜在的候选者面临着漫长的等待时间。需要更好地了解手术需求与提供手术能力之间的差距。本研究的目的是定量和描述加拿大有资格接受减重手术的人群与无资格接受手术的人群和手术接受者之间的差异。
分析了 2007-09 年全国代表性加拿大健康测量调查（CHMS）成年（年龄>20 岁）受访者的数据，以估计手术合格和不合格人群的患病率和特征。使用联邦授权的医疗保健管理数据（2007-08 年）来描述手术接受者。
在 2007-09 年，估计有 150 万肥胖的加拿大成年人符合减重手术的资格标准。1920 万人不符合手术条件（340 万肥胖和 1580 万非肥胖）。加拿大有资格接受手术的人平均 BMI 为 40.1kg/m2（95%CI 39.3 至 40.9kg/m2），与不符合手术条件的肥胖人群相比，他们更有可能是女性（62%比 44%）、40-59 岁（55%比 48%）、受教育程度较低（43%比 35%）、社会经济地位最低三分之一（41%比 34%）、不活跃（73%比 59%）。与不合格人群相比，有资格接受手术的受访者的自我评估心理健康和生活质量较低，合并症较高。2007-09 年间，加拿大有资格接受手术的人实际上接受了公共资助的减重手术的比例为每年 0.1%。手术接受者（n=847）的平均年龄为 43.6 岁（SD 11.1），82%为女性。除 2 型糖尿病外，手术接受者的肥胖相关合并症患病率明显低于有资格接受手术的人。
接受公共资助的减重手术的加拿大有资格接受手术的人的比例非常低。在社会人口统计学特征和合并症患病率方面，有资格接受手术的患者与手术接受者之间存在显著差异。
