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Access to surgery

Systematic review to access inequities to bariatric surgery

Outcomes may have important implications for the delivery of bariatric surgery

A systematic review of the literature exploring the inequities to the access of bariatric surgery is being conducted as part of the PROSPERO International prospective register of systematic reviews. An overview of the review was announced online in Systematic Reviews published by BioMed Central.

It is well documented that the population who has bariatric surgery, is not a true reflection of those who actually need it the most. As a result, this review will look to provide answer to whether differences exist in the socio-demographic profile of obese adults who are eligible for bariatric surgery compared to those who receive bariatric surgery.

The study will include observational studies that compared at least one of the PROGRESS-PLUS socio-demographic characteristics of patients eligible for bariatric surgery to those who actually received the procedure. Articles published in the year 1980 to present with no language restrictions will be included.

Adult patients over the age of 18 meeting the NIH criteria for bariatric surgery will be included, irrespective of geographical location and will include the following procedures: Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable gastric band, vertical banded gastroplasty, jejunoileal bypass, biliopancreatic diversion, duodenal switch, mini-gastric bypass, loop gastric bypass, gastric placation, gastric balloon, or scopinaro procedure. Both open and laparoscopic approaches will be considered.

The focus will be on the patients who are eligible for and received bariatric surgery, and those who are eligible for but did not receive bariatric surgery.

In addition, unpublished studies and grey literature will be sought through internet searches with specific websites targeted, including:

  • Statistics Canada
  • Royal College of Physicians and Surgeons of Canada:
  • Institute for Clinical Evaluative Sciences
  • Canadian Institute for Health Information
  • American College of Surgeons
  • National Centre for Health Statistics
  • National Institutes of Health
  • Agency for Healthcare Research and Quality
  • Royal College of Surgeons of England
  • Health and Social Care Information Centre
  • European Institute for Health Records
  • Royal Australasian College of Surgeons
  • Australian Institute for Health and Welfare

“We expect our results will have important implications for the delivery of bariatric surgery by providing some leads to the barriers to accessing these operations,” the authors write. “Findings of inequities in the access to bariatric surgery will be used to inform the design of qualitative research which will provide insight into what drives the identified factors to act as barriers and help prioritize solutions to bridge the care gap.”

To access the paper, please click here

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