Skip to main content
Top
Published in: Systematic Reviews 1/2014

Open Access 01-12-2014 | Protocol

Health inequity in access to bariatric surgery: a protocol for a systematic review

Authors: Timothy D Jackson, Rujun Zhang, Dresden Glockler, Jason Pennington, Jacinta I Reddigan, Ori D Rotstein, Janet Smylie, Laure Perrier, Lesley Gotlib Conn

Published in: Systematic Reviews | Issue 1/2014

Login to get access

Abstract

Background

Bariatric surgery is the only weight-loss treatment available that results in both sustained weight loss and improvements of obesity-related comorbidities. Individuals who meet the eligibility criteria for bariatric surgery are generally older, come from racial or ethnic minorities, are economically disadvantaged, and have low levels of education. However, the population who actually receives bariatric surgery does not reflect the individuals who need it the most. The objective is to conduct a systematic review of the literature exploring the inequities to the access of bariatric surgery.

Methods/Design

EMBASE and Medline databases will be searched for observational studies that compared at least one of the PROGRESS-PLUS sociodemographic 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. For inclusion, studies must only include adults (≥18 years old) who meet National Institutes of Health (NIH) eligibility criteria for bariatric surgery defined as having either (1) a body mass index (BMI) of 40 kg/m2 or greater; or (2) BMI of 35 kg/m2 or greater with significant weight-related comorbidities. Eligible interventions will include malabsorptive, restrictive, and mixed bariatric procedures.

Discussion

There appears to be inequities in access to bariatric surgery. In order to resolve the health inequity in the treatment of obesity, a synthesis of the literature is needed to explore and identify barriers to accessing bariatric surgery. It is anticipated that the results from this systematic review will have important implications for advancing solutions to minimize inequities in the utilization of bariatric surgery.
Appendix
Available only for authorised users
Literature
1.
go back to reference Stewart ST, Cutler DM, Rosen AB: Forecasting the effects of obesity and smoking on U.S. life expectancy. N Engl J Med. 2009, 361: 2252-2260. 10.1056/NEJMsa0900459.CrossRefPubMedPubMedCentral Stewart ST, Cutler DM, Rosen AB: Forecasting the effects of obesity and smoking on U.S. life expectancy. N Engl J Med. 2009, 361: 2252-2260. 10.1056/NEJMsa0900459.CrossRefPubMedPubMedCentral
2.
go back to reference World Health Organization: Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894: 1-253. World Health Organization: Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894: 1-253.
3.
go back to reference McGuire S, Shields M, Carroll MD, Ogden CL: Adult obesity prevalence in Canada and the United States. NCHS data brief no. 56, Hyattsville, MD: National Center for Health Statistics, 2011. Adv Nutr. 2011, 2: 368-369. 10.3945/an.111.000497.CrossRefPubMedPubMedCentral McGuire S, Shields M, Carroll MD, Ogden CL: Adult obesity prevalence in Canada and the United States. NCHS data brief no. 56, Hyattsville, MD: National Center for Health Statistics, 2011. Adv Nutr. 2011, 2: 368-369. 10.3945/an.111.000497.CrossRefPubMedPubMedCentral
5.
go back to reference Sturm R, Hattori A: Morbid obesity rates continue to rise rapidly in the United States. Int J Obes (Lond). 2013, 37: 889-891. 10.1038/ijo.2012.159.CrossRef Sturm R, Hattori A: Morbid obesity rates continue to rise rapidly in the United States. Int J Obes (Lond). 2013, 37: 889-891. 10.1038/ijo.2012.159.CrossRef
6.
go back to reference Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB: Years of life lost due to obesity. JAMA. 2003, 289: 187-193. 10.1001/jama.289.2.187.CrossRefPubMed Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB: Years of life lost due to obesity. JAMA. 2003, 289: 187-193. 10.1001/jama.289.2.187.CrossRefPubMed
7.
go back to reference Chang SH, Pollack LM, Colditz GA: Life years lost associated with obesity-related diseases for U.S. non-smoking adults. PLoS One. 2013, 8: e66550-10.1371/journal.pone.0066550.CrossRefPubMedPubMedCentral Chang SH, Pollack LM, Colditz GA: Life years lost associated with obesity-related diseases for U.S. non-smoking adults. PLoS One. 2013, 8: e66550-10.1371/journal.pone.0066550.CrossRefPubMedPubMedCentral
8.
go back to reference Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E: Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2006, 176: S1-S13.CrossRef Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E: Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2006, 176: S1-S13.CrossRef
9.
go back to reference Appel LJ, Clark JM, Yeh HC, Wang NY, Coughlin JW, Daumit G, Miller ER, Calcin A, Jerone GJ, Geller S, Noronha G, Pozefsky T: Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011, 365: 1959-1968. 10.1056/NEJMoa1108660.CrossRefPubMedPubMedCentral Appel LJ, Clark JM, Yeh HC, Wang NY, Coughlin JW, Daumit G, Miller ER, Calcin A, Jerone GJ, Geller S, Noronha G, Pozefsky T: Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011, 365: 1959-1968. 10.1056/NEJMoa1108660.CrossRefPubMedPubMedCentral
10.
go back to reference Wadden TA, Volger S, Sarwer DB, Vetter ML, Tsai AG, Berkowitz RI, Kumanuika S, Schmitz KH, Diewalk LK, Barg R, Chittams J, Moore RH: A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011, 365: 1969-1979. 10.1056/NEJMoa1109220.CrossRefPubMedPubMedCentral Wadden TA, Volger S, Sarwer DB, Vetter ML, Tsai AG, Berkowitz RI, Kumanuika S, Schmitz KH, Diewalk LK, Barg R, Chittams J, Moore RH: A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011, 365: 1969-1979. 10.1056/NEJMoa1109220.CrossRefPubMedPubMedCentral
11.
go back to reference Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K: Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004, 292: 1724-1737. 10.1001/jama.292.14.1724.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K: Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004, 292: 1724-1737. 10.1001/jama.292.14.1724.CrossRefPubMed
12.
go back to reference Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lönroth H, Näslund I, Olbers T, Stenlöf K, Torgerson J, Agren G, Carlsson LM, Swedish Obese Subjects Study: Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007, 357: 741-752. 10.1056/NEJMoa066254.CrossRefPubMed Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lönroth H, Näslund I, Olbers T, Stenlöf K, Torgerson J, Agren G, Carlsson LM, Swedish Obese Subjects Study: Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007, 357: 741-752. 10.1056/NEJMoa066254.CrossRefPubMed
13.
go back to reference NIH conference: Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991, 115: 956-961.CrossRef NIH conference: Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991, 115: 956-961.CrossRef
14.
go back to reference Flum DR, Belle SH, King WC, Wahed AS, Berk P, Chapman W, Pories W, Courcoulas A, McCloskey C, Mitchell J, Patterson E, Pomp A, Staten MA, Yanovski SZ, Thrilby R, Wolfe B, Longitudinal Assessment of Bariatric Surgery (LABS) Consortium: Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009, 361: 445-454.CrossRefPubMed Flum DR, Belle SH, King WC, Wahed AS, Berk P, Chapman W, Pories W, Courcoulas A, McCloskey C, Mitchell J, Patterson E, Pomp A, Staten MA, Yanovski SZ, Thrilby R, Wolfe B, Longitudinal Assessment of Bariatric Surgery (LABS) Consortium: Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009, 361: 445-454.CrossRefPubMed
15.
go back to reference Hutter MM, Schirmer BD, Jones DB, Ko CY, Cohen ME, Merkow RP, Nguyen NT: First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011, 254: 410-420. 10.1097/SLA.0b013e31822c9dac.CrossRefPubMedPubMedCentral Hutter MM, Schirmer BD, Jones DB, Ko CY, Cohen ME, Merkow RP, Nguyen NT: First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011, 254: 410-420. 10.1097/SLA.0b013e31822c9dac.CrossRefPubMedPubMedCentral
16.
go back to reference Finks JF, Kole KL, Yenumula PR, English WJ, Krause KR, Carlin AM, Genaw JA, Banerjee M, Birkmever JD, Birkmeye NJ, Michigan Bariatric Surgery Collaborative, from the Centre for Healthcare Outcomes and Policy: Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2011, 254: 633-640. 10.1097/SLA.0b013e318230058c.CrossRefPubMed Finks JF, Kole KL, Yenumula PR, English WJ, Krause KR, Carlin AM, Genaw JA, Banerjee M, Birkmever JD, Birkmeye NJ, Michigan Bariatric Surgery Collaborative, from the Centre for Healthcare Outcomes and Policy: Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2011, 254: 633-640. 10.1097/SLA.0b013e318230058c.CrossRefPubMed
17.
go back to reference Encinosa WE, Bernard DM, Du D, Steiner CA: Recent improvements in bariatric surgery outcomes. Med Care. 2009, 47: 531-535. 10.1097/MLR.0b013e31819434c6.CrossRefPubMed Encinosa WE, Bernard DM, Du D, Steiner CA: Recent improvements in bariatric surgery outcomes. Med Care. 2009, 47: 531-535. 10.1097/MLR.0b013e31819434c6.CrossRefPubMed
18.
go back to reference Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L, Clegg AJ: The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009, 13: 1-357. iiiCrossRef Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L, Clegg AJ: The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009, 13: 1-357. iiiCrossRef
19.
go back to reference Cremieux PY, Ghosh A, Yang HE, Buessing M, Buchwald H, Shikora SA: Return on investment for bariatric surgery. Am J Manag Care. 2008, 14: e5-e6.PubMed Cremieux PY, Ghosh A, Yang HE, Buessing M, Buchwald H, Shikora SA: Return on investment for bariatric surgery. Am J Manag Care. 2008, 14: e5-e6.PubMed
20.
go back to reference Sampalis JS, Liberman M, Auger S, Christou NV: The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004, 14: 939-947. 10.1381/0960892041719662.CrossRefPubMed Sampalis JS, Liberman M, Auger S, Christou NV: The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004, 14: 939-947. 10.1381/0960892041719662.CrossRefPubMed
21.
go back to reference Flum DR, Khan TV, Dellinger EP: Toward the rational and equitable use of bariatric surgery. JAMA. 2007, 298: 1442-1444. 10.1001/jama.298.12.1442.CrossRefPubMed Flum DR, Khan TV, Dellinger EP: Toward the rational and equitable use of bariatric surgery. JAMA. 2007, 298: 1442-1444. 10.1001/jama.298.12.1442.CrossRefPubMed
22.
go back to reference Whitehead M: The concepts and principles of equity and health. Int J Health Serv. 1992, 22: 429-445. 10.2190/986L-LHQ6-2VTE-YRRN.CrossRefPubMed Whitehead M: The concepts and principles of equity and health. Int J Health Serv. 1992, 22: 429-445. 10.2190/986L-LHQ6-2VTE-YRRN.CrossRefPubMed
23.
go back to reference Martin M, Beekley A, Kjorstad R, Sebesta J: Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis. Surg Obes Relat Dis. 2010, 6: 8-15. 10.1016/j.soard.2009.07.003.CrossRefPubMed Martin M, Beekley A, Kjorstad R, Sebesta J: Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis. Surg Obes Relat Dis. 2010, 6: 8-15. 10.1016/j.soard.2009.07.003.CrossRefPubMed
24.
go back to reference Santry HP, Gillen DL, Lauderdale DS: Trends in bariatric surgical procedures. JAMA. 2005, 294: 1909-1917. 10.1001/jama.294.15.1909.CrossRefPubMed Santry HP, Gillen DL, Lauderdale DS: Trends in bariatric surgical procedures. JAMA. 2005, 294: 1909-1917. 10.1001/jama.294.15.1909.CrossRefPubMed
25.
go back to reference Wallace AE, Young-Xu Y, Hartley D, Weeks WB: Racial, socioeconomic, and rural–urban disparities in obesity-related bariatric surgery. Obes Surg. 2010, 20: 1354-1360. 10.1007/s11695-009-0054-x.CrossRefPubMed Wallace AE, Young-Xu Y, Hartley D, Weeks WB: Racial, socioeconomic, and rural–urban disparities in obesity-related bariatric surgery. Obes Surg. 2010, 20: 1354-1360. 10.1007/s11695-009-0054-x.CrossRefPubMed
26.
go back to reference Padwal RS, Chang HJ, Klarenbach S, Sharma AM, Majumdar SR: Characteristics of the population eligible for and receiving publicly funded bariatric surgery in Canada. Int J Equity Health. 2012, 11: 54-10.1186/1475-9276-11-54.CrossRefPubMedPubMedCentral Padwal RS, Chang HJ, Klarenbach S, Sharma AM, Majumdar SR: Characteristics of the population eligible for and receiving publicly funded bariatric surgery in Canada. Int J Equity Health. 2012, 11: 54-10.1186/1475-9276-11-54.CrossRefPubMedPubMedCentral
27.
go back to reference Evans T, Brown H: Road traffic crashes: operationalizing equity in the context of health sector reform. Inj Control Saf Promot. 2003, 10: 11-12. 10.1076/icsp.10.1.11.14117.CrossRefPubMed Evans T, Brown H: Road traffic crashes: operationalizing equity in the context of health sector reform. Inj Control Saf Promot. 2003, 10: 11-12. 10.1076/icsp.10.1.11.14117.CrossRefPubMed
29.
go back to reference Sampson M, McGowan J, Cogo E, Grimshaw J, Moher D, Lefebvre C: An evidence-based practice guideline for the peer review of electronic search strategies. J Clin Epidemiol. 2009, 62: 944-952. 10.1016/j.jclinepi.2008.10.012.CrossRefPubMed Sampson M, McGowan J, Cogo E, Grimshaw J, Moher D, Lefebvre C: An evidence-based practice guideline for the peer review of electronic search strategies. J Clin Epidemiol. 2009, 62: 944-952. 10.1016/j.jclinepi.2008.10.012.CrossRefPubMed
Metadata
Title
Health inequity in access to bariatric surgery: a protocol for a systematic review
Authors
Timothy D Jackson
Rujun Zhang
Dresden Glockler
Jason Pennington
Jacinta I Reddigan
Ori D Rotstein
Janet Smylie
Laure Perrier
Lesley Gotlib Conn
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2014
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/2046-4053-3-15

Other articles of this Issue 1/2014

Systematic Reviews 1/2014 Go to the issue