Abstract
Background
The objective of the study was to determine the level of guidance provided by or to government health departments across different regions of Australia on publicly funded bariatric surgery.
Methods
Bariatric surgery policies and guidelines were sought from each Australian state (n = 6) and territory (n = 2) government health department and compared in relation to their origins, level of guidance on patient eligibility and priority, as well as recommendations for patient care, including follow-up surgical services. Comparison with national guidelines on bariatric surgery from Australia, the UK and USA was also made.
Results
Five of the eight states and territories had policies or guidelines informing practice. There was little uniformity among regional guidelines and variable consistency with national guidelines (e.g., defining obesity related comorbidity). Recommendations differed on patient eligibility, and none of the state documents mentioned re-operative bariatric or body-contouring surgery. There was limited guidance on prioritisation of eligible patients and gastric banding adjustments. Pre- and post-surgical multidisciplinary care was generally recommended.
Conclusions
Policies and guidelines on publicly funded bariatric surgery are highly variable across Australia and at times inconsistent with national guidelines. Insufficient guidance exists regarding the prioritisation of eligible patients and follow-up surgical services. These findings have implications for policy, research and practice and are particularly important in health service environments with resource constraints and inequitable patient access to services.
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Acknowledgments
The authors acknowledge the assistance of the policy officers from the health departments of Australian state and territory governments.
Funding
This work was supported by a National Health and Medical Research Council (NHMRC) Partnership Project Grant (APP1076899). AV is supported by a NHMRC Research Fellowship.
Conflict of Interest
The authors declare that they have no competing interest.
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Sharman, M.J., Hensher, M., Wilkinson, S. et al. Review of Publicly-Funded Bariatric Surgery Policy in Australia—Lessons for More Comprehensive Policy Making. OBES SURG 26, 817–824 (2016). https://doi.org/10.1007/s11695-015-1806-4
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DOI: https://doi.org/10.1007/s11695-015-1806-4