Goubar Thomas, Goubar Christopher, Fenton-Lee Douglas, Stefanidis Aneta, Macdonald Peter S, Rushworth R Louise
St Vincent's Hospital Sydney, Darlinghurst, Australia.
The University of Notre Dame Australia, Fremantle, Australia.
Obes Surg. 2025 Mar;35(3):1026-1035. doi: 10.1007/s11695-025-07699-7. Epub 2025 Feb 6.
Obesity is increasingly prevalent and associated with higher morbidity and mortality. Bariatric surgery, particularly sleeve gastrectomy, provides durable weight loss and improves obesity-related conditions like type 2 diabetes and cardiovascular disease. Despite its benefits, significant concerns regarding inequities in access to bariatric surgery persist. This study aims to evaluate recent trends in bariatric surgery rates and to investigate patterns of access to bariatric surgery.
A population-based study of age-adjusted bariatric procedure rates in adults in NSW, Australia, was conducted over the financial years 2013/14 to 2021/22. Trends in age-adjusted procedure rates were assessed by demographics and healthcare settings.
In 2021/22, 179.6 bariatric procedures per 100,000 population were performed, an 89.7% increase since 2013/14 (p < 0.001). Laparoscopic sleeve gastrectomy, the most common procedure, increased by 94.1% to 112.6/100,000/year (p < 0.001). Females had 3.6 times higher rates than males (232.3/100,000/year vs 64.9/100,000/year). The greatest increases occurred in younger patients (125.9% in the 18-24 age group; 142.4% in the 25-34 age group, p < 0.001). Private hospital rates were 15.6 times higher than public (132.2/100,000/year vs 8.5/100,000/year) and rose 92.3% (p < 0.001), whilst public hospital rates declined by 17.9% (p = NS). Patients from regional areas had the highest rates (175.7/100,000/year) and largest increase (169.8%; 89.4/100,000/year to 241.8/100,000/year, p < 0.001).
Bariatric surgery rates continue to increase, particularly among females, despite similar obesity prevalence between sexes. Most surgery is conducted in the private sector, suggesting differential access based on financial circumstances. Rates are highest in younger people, although obesity-related comorbidities increase with age. Regional patients undergo surgery at higher rates than rural patients despite greater obesity prevalence with increasing rurality. Efforts to address these disparities are essential to improve equitable access to obesity treatments.
肥胖症日益普遍，且与更高的发病率和死亡率相关。减肥手术，尤其是袖状胃切除术，能实现持久的体重减轻，并改善与肥胖相关的病症，如2型糖尿病和心血管疾病。尽管有这些益处，但在获得减肥手术的机会方面存在不平等的重大问题依然存在。本研究旨在评估减肥手术率的近期趋势，并调查获得减肥手术的模式。
在2013/14至2021/22财政年度，对澳大利亚新南威尔士州成年人的年龄调整后减肥手术率进行了一项基于人群的研究。通过人口统计学和医疗保健环境评估年龄调整后手术率的趋势。
在2021/22年度，每10万人口中进行了179.6例减肥手术，自2013/14年度以来增加了89.7%（p<0.001）。最常见的手术腹腔镜袖状胃切除术增加了94.1%，达到每年112.6/10万（p<0.001）。女性的手术率是男性的3.6倍（每年232.3/10万 vs 每年64.9/10万）。增幅最大的是年轻患者（18 - 24岁年龄组增加了125.9%；25 - 34岁年龄组增加了142.4%，p<0.001）。私立医院的手术率比公立医院高15.6倍（每年132.2/10万 vs 每年8.5/10万），且上升了92.3%（p<0.001），而公立医院的手术率下降了17.9%（p = 无统计学意义）。来自地区的患者手术率最高（每年175.7/10万）且增幅最大（169.8%；从每年89.4/10万增至每年241.8/10万，p<0.001）。
尽管男女肥胖患病率相似，但减肥手术率仍在继续上升，尤其是在女性中。大多数手术在私立部门进行，这表明基于经济状况的获得机会存在差异。年轻人的手术率最高，尽管与肥胖相关的合并症随年龄增加。尽管随着农村地区肥胖患病率增加，但地区患者的手术率高于农村患者。解决这些差异的努力对于改善肥胖治疗的公平可及性至关重要。
