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More than half of procedures on 45 to 64yrs
The latest report into obesity from the Health and Social Care Information Centre has reported that in 2013-14, 3,391 adults aged 45 to 64 underwent inpatient bariatric surgery procedures in England, accounting for 53.1 per cent (Table 1) of all such procedures recorded by hospitals (6,380). The report also shows a 20.4 per cent decrease in the total number of inpatient bariatric surgery procedures, compared to 2012-13 (8,020). However, nearly half of this decrease can be attributed to one hospital trust now recording bariatric maintenance procedures in an outpatient rather than inpatient setting.
The report, ‘Statistics on Obesity, Physical Activity and Diet, England 2015’, presents a range of information from a variety of recent publications and new analyses not previously published. It reveals that London had the highest admission rate for inpatient bariatric surgery procedures (19 per 100,000 of the population) across Commissioning Regions in 2013-14, whilst the Midlands and East of England had the lowest (7 per 100,000 of the population).
According to the report, “Outpatient procedures are not included in these figures due to the primary diagnosis code being poorly populated, and there being no certainty that procedures are for obesity diagnoses. This should be considered when interpreting changes over time as recording and clinical practice may change and in particular, practices vary between hospitals as to whether some episodes are carried out or recorded in outpatient or inpatient settings. One provider in particular, Derby Hospitals NHS Foundation Trust recorded 183 inpatient admissions in 2013/14 with a primary diagnosis of obesity compared to 920 inpatient admissions in 2012-13 which is a large part of the decrease seen on the national figures (down 1,632 or 15 per cent). They have also recorded a decrease of 739 inpatient bariatric surgical procedures this year mainly due to gastric band maintenance procedures which is a large part of the decrease seen on the national figures (down 1,640 – 20 per cent). This Trust has also recorded 594 procedures in outpatient settings in 2013/14 with a primary procedure code of gastric band maintenance compared to none in 2012/13. These procedures are not included in this report as they were performed in an outpatient setting.”
In 2013-14, there were 6,384 recorded Finished Consultant Episodes (FCEs) with a primary diagnosis of obesity and a main or secondary procedure of bariatric surgery. This is 20 per cent less episodes than in 2012/13 (8,024). Females continue to account for the majority of these (Table 2); there were 4,823 such recorded FCEs for females and 1,560 for males. This is a similar ratio to 2012-13 (6,080 for females and 1,944 for males) and 2003-04 (378 for females and 96 for males).
In 2013-14, there were 9,325 Finished Admission Episodes (FAEs) in NHS hospitals with a primary diagnosis of obesity. This is 15 per cent less admissions than in 2012-13 (10,957), although this is over five times as high as ten years ago in 2003/04 (1,711).
London had the highest number of recorded FCEs for bariatric surgery in 2013/14 (1,559), while East of England had the lowest (294). The North East had the highest number of FCEs per 100,000 of the population (46). The Region with the lowest rate was East of England with 5 FCEs per 100,000 of the population.
When comparing Commissioning Regions, the date reveals that:
- The North of England had the highest number of recorded FCEs for bariatric surgery in 2013/14 (2,259), while the Midlands and East of England had the lowest (1,157).
- London had the highest number of FCEs per 100,000 of the population (19). The Region with the lowest rate was the Midlands and East of England with 7 FCEs per 100,000 of the population.
The publication also notes a marked increase in the proportion of adults that were obese from 13.2 per cent in 1993 to 26.0 per cent in 2013 for men, and from 16.4 per cent to 23.8 per cent for women. The proportions that were overweight including obese increased from 57.6 per cent to 67.1 per cent in men and from 48.6 per cent to 57.2 per cent in women (Figure 1).
Meanwhile, the prevalence of severe obesity (BMI≥40) has increased since 1993 for both men and women (Figure 2).
In reception year (aged 4-5) in 2013-14, the proportion of obese children (9.5 per cent) was higher than in 2012-13 (9.3 per cent) but lower than in 2006-07 (9.9 per cent). In Year 6 (age 10-11) in 2013/14, the proportion of obese children (19.1 per cent) was higher than in 2012-13 (18.9 per cent) and also higher than in 2006-07 (17.5 per cent).
There were 15 per cent fewer hospital admissions with a primary diagnosis of obesity in 2013-14 (9,330) compared to 2012-13 (10,960), although latest figures are more than five times as high as 2003-04 figures (1,710).
The number of drug items dispensed for treating obesity in 2013 (563,000) rose by 44 per cent from 2012 (392,000) but this may be due to a stock shortage of Orlistat in 2012. The figure for 2013 is a decrease of 61 per cent on 2009 (1,450,000) when the number of drug items dispensed for treating obesity reached a peak. In 2013, Orlistat accounted for all prescription items dispensed for the treatment of obesity, at a net ingredient cost of £19.7 million.
The North of England had the greatest number of prescription items in total (205,000) and also had the greatest number of prescription items dispensed per head of population (1,350 items per 100,000). London had the lowest figures with 91,000 prescription items but the South of England had the lowest per head of population at 780 items per 100,000 population.
To access the report, please click here
To access the Tables and Figures from the report, please click here