Deakin Health Economics, School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia.
Menzies Institute for Medical Research, University of Tasmania, Medical Sciences Precinct, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
Obes Surg. 2022 Sep;32(9):3013-3022. doi: 10.1007/s11695-022-06188-5. Epub 2022 Jul 8.
The prevalence of obesity is increasing in developed countries, including Australia. There is evidence that bariatric surgery is effective in losing weight and reducing risk of chronic diseases. However, access to bariatric surgery remains limited in the public health sector.
We modelled population-based estimates of the likely numbers of people eligible for bariatric surgery in Australia using the recent Australian New Zealand Metabolic and Obesity Surgery Society (ANZMOSS) framework and estimated the potential costs that would be incurred from primary and subsequent reoperations in both public and private sector.
The annual number of newly eligible patients is expected to rise, and hence the gap in demand is increasing relative to current baseline supply. If a 5-year program to treat all currently eligible patients was implemented, the maximum yearly demand is projected to be 341,343 primary surgeries, more than eight times the existing capacity of public and private sector, which can only offer 41,534 surgeries/year. A nine-fold increase is expected if we treat currently eligible patients over a 5-year program and all newly eligible patients as they occur each year.
Our results highlighted the currently highly skewed distribution of bariatric surgeries between the private and public sectors. Improving access would bring substantial benefits to many Australians, given the demonstrated cost-effectiveness and cost savings. This requires a major increase in resourcing for publicly-funded access to bariatric surgery in the first instance. A national review of priorities and resourcing for all modes of obesity treatment is required in Australia.
肥胖症在发达国家（包括澳大利亚）的发病率正在上升。有证据表明，减重手术在减肥和降低慢性病风险方面是有效的。然而，在公共卫生部门，接受减重手术的机会仍然有限。
我们使用最近的澳大利亚新西兰代谢和肥胖手术学会（ANZMOSS）框架，对澳大利亚有资格接受减重手术的人群进行了基于人群的估计，并估计了在公共和私人部门进行初级和后续再次手术的潜在成本。
预计新符合条件的患者人数将增加，因此相对于目前的基线供应，需求差距正在扩大。如果实施一个为期 5 年的计划来治疗所有目前符合条件的患者，预计每年的最大需求将是 341343 例初次手术，这是公共和私人部门现有能力的 8 倍以上，公共和私人部门每年只能提供 41534 例手术。如果我们在 5 年内治疗所有目前符合条件的患者，并在每年有新符合条件的患者时对其进行治疗，预计需求将增加 9 倍。
我们的研究结果突出了私人和公共部门之间目前存在的严重不平衡的减重手术分布情况。鉴于减重手术的成本效益和成本节约已得到证实，改善获取途径将为许多澳大利亚人带来巨大的益处。这首先需要大幅增加公共资金获得减重手术的资源。澳大利亚需要对所有肥胖症治疗模式的优先事项和资源进行国家审查。
