Healthcare delivery and information provision in bariatric surgery in Germany: qualitative interviews with bariatric surgeons

Abstract

Background There are several healthcare professionals involved in health information provision regarding bariatric surgery, such as bariatric surgeons, nutritionists, and medical doctors in outpatient settings. Trustworthy health information supports patients in understanding their diagnosis, treatment decisions, and possible prognosis. Therefore, it is necessary to provide health information on bariatric surgery. This study has two distinct objectives. The first is to outline the delivery of healthcare regarding bariatric surgery in Germany. The second is to describe the information provision within healthcare delivery. Methods We conducted 15 semi-structured telephone interviews with bariatric surgeons between April 2018 and February 2019. The interviews were audio recorded and transcribed verbatim. The interview guide consisted of four sections (information about the clinic/surgeon and surgical procedures, preoperative procedure, postoperative procedure, information needs). The transcribed interviews were analyzed using qualitative content analysis supported by MAXQDA software. Results The pre- and postoperative processes differed substantially between clinics. Additionally, every bariatric clinic had its own information provision concept. There were several cost-related issues the surgeons claimed to be relevant for patients, such as nutritional blood tests or postoperative psychotherapy. These issues were often caused by unclearness of responsibility within the medical disciplines involved. Conclusion Healthcare delivery in bariatric surgery in Germany is heterogeneous in terms of pre- and postoperative care. Therefore, preoperative information provision between the clinics differs. The impact of this heterogeneous healthcare delivery and information provision on patients’ information needs regarding bariatric surgery should be further investigated among patients and other healthcare professionals involved.

Information needs of patients undergoing bariatric surgery in Germany: a qualitative study

“…We previously published a study from the overall project "Information needs of patients undergoing bariatric surgery" [ 12 ]. In a previously published study, interviews were conducted with bariatric surgeons.…”

“…This qualitative interview study is part of a larger research project to identify the information needs of patients undergoing BS. We designed a project with three qualitative interview studies (with patients, bariatric surgeons [ 12 ] and nutritionists) to identify the information needs of patients undergoing BS and map the information provision within the pre- and postoperative hospital process. The present study targets patients’ views on information needs and healthcare delivery in BS.…”

“…Since the delivery of healthcare and the provision of information on BS in Germany is heterogeneous and depends on the clinic [ 12 ], the fact that 4/14 (28.6%) interviewees were operated on in the same hospital could lead to selection bias. All other patients underwent surgery at different hospitals.…”

“…Therefore, we assume that there is an increased need for information, since in addition to the question of whether an operation should be performed, the question of the type of procedure also arises. In addition, healthcare delivery as well as the provision of information is heterogeneous in Germany [ 12 ]. Hence, identifying the information needs relating to BS patients’ perspectives on information provision and related information needs is necessary.…”

Behavioral Interventions After Bariatric Surgery

“…Lastly, payer coverage of the most commonly assessed services such as nutrition, physical activity, and behavioral health is limited, leaving the majority of the available information based in research settings or limited by financial constraints [ 8 , 9 , 10 ]. Despite bariatric providers identifying postoperative counseling as an area of importance and need, most cite cost as the primary barrier to being able to provide these services [ 11 ]. With these postoperative challenges in mind, this article aims to summarize the current state of the literature on behavioral interventions after bariatric surgery and highlight opportunities for future research (Fig.…”