Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Global Health Economics and Outcomes Research, Intuitive Surgical, Sunnyvale, California; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Surg Obes Relat Dis. 2024 Jun;20(6):554-563. doi: 10.1016/j.soard.2023.12.017. Epub 2024 Jan 8.
Metabolic and bariatric surgery (MBS) is the most effective and durable treatment for obesity; however, access to MBS is not equitable.
To determine the rate of MBS among eligible adults with obesity by demographics, health characteristics, and geography to better define populations that would benefit from resources to reduce barriers to access for this treatment.
Adults with obesity were identified in the US employer-based retrospective claims database (Merative™).
Rates of MBS were examined across demographics (age, sex, region, year, health plan type) health characteristics (obesity-related comorbidities, healthcare costs, inpatient admissions), and by state. Given differences in coverage requirements, rates are examined for 2 populations: Class 2 (BMI 35-39.9 kg/m) and Class 3 (BMI 40+ kg/m) obesity.
Of the 777,565 eligible adults, 49,371 (6.4%) had MBS; 3.2% of those with Class 2 and 8.3% of those with Class 3 obesity had MBS. MBS rates varied substantially by demographic and health characteristics, ranging from 1% to 14%, and from 2% to 41% among those with Class 2 and Class 3 obesity, respectively. Geographically, rates ranged from 0% (Hawaii) to 7.4% (New Mexico) for those with Class 2 Obesity and from 4.2% (Hawaii) to 15.3% (Mississippi) among those with Class 3 Obesity.
Use of MBS among eligible adults with obesity varies substantially across characteristics, indicating inequity in access to this treatment. To ensure greater access to the most effective treatment for obesity, policies should be implemented to reduce or eliminate barriers to care.
代谢和减重手术（MBS）是治疗肥胖症最有效和持久的方法；然而，获得 MBS 的机会并不公平。
通过人口统计学、健康特征和地理位置来确定符合条件的肥胖成年人中 MBS 的比率，以便更好地确定受益于资源以减少获得这种治疗的障碍的人群。
在美国雇主回溯性索赔数据库（Merative™）中确定肥胖成年人。
根据人口统计学（年龄、性别、地区、年份、健康计划类型）、健康特征（肥胖相关合并症、医疗保健费用、住院入院情况）和各州情况，检查 MBS 的比率。鉴于覆盖范围要求的差异，对于 2 个群体检查比率：2 级（BMI 35-39.9 kg/m）和 3 级（BMI 40+ kg/m）肥胖。
在 777,565 名符合条件的成年人中，有 49,371 人（6.4%）接受了 MBS；3.2%的 2 级肥胖患者和 8.3%的 3 级肥胖患者接受了 MBS。MBS 率因人口统计学和健康特征而异，范围从 1%到 14%，分别为 2 级和 3 级肥胖患者的 2%到 41%。在地理上，2 级肥胖患者的比率从 0%（夏威夷）到 7.4%（新墨西哥州）不等，而 3 级肥胖患者的比率从 4.2%（夏威夷州）到 15.3%（密西西比州）不等。
符合条件的肥胖成年人中 MBS 的使用情况因特征而异，表明获得这种治疗的机会不平等。为确保更广泛地获得肥胖症的最有效治疗方法，应实施政策以减少或消除护理障碍。
