Socioeconomic deprivation remains a significant barrier in the choice of bariatric surgery even when full medical expense coverage is present

Fysekidis, Marinos; Catheline, Jean-Marc; Kouacou, Narcisse; Bihan, H.; Cohen, R.

doi:10.1016/j.soard.2016.01.028

Cited by 16 publications

(9 citation statements)

References 21 publications

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“…Thus, its psychometric properties may be different in specific patient populations. However, the EPICES score was also found to be independently associated with glycemic control, microvascular complications and renal complications in patients with diabetes , and with a lower acceptance of bariatric surgery in morbidly obese patients . Lastly, the EPICES score may not be transposable to populations from different ethnic or cultural backgrounds.…”

Section: Discussionmentioning

confidence: 98%

Social deprivation and stroke severity on admission: a French cohort study in Burgundy and the West Indies – Guyana region

Béjot

Guilloteau

Joux

et al. 2017

Euro J of Neurology

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Section: Discussionmentioning

confidence: 98%

Social deprivation and stroke severity on admission: a French cohort study in Burgundy and the West Indies – Guyana region

Béjot

Guilloteau

Joux

et al. 2017

Euro J of Neurology

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“…In countries with a private healthcare system, some of these variations might be explained by financial inequalities. However, in countries with a publicly funded system, no obvious reason for these disparities are apparent [30,31]. Few studies have systematically analyzed the factors that cause the variation in receiving bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic factors, body mass index and bariatric surgery: a Swedish nationwide cohort study

et al. 2019

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Background: Bariatric surgery is considered to be the most effective method of weight loss today. The aim of the present Swedish study, which was performed in a country that has universal health care, was to investigate if there is an association between socioeconomic factors and bariatric surgery by taking body mass index (BMI) into account. Methods: In this prospective cohort study, BMI data were collected for the period 1985-2010 from the Military Service Conscription Register (for men) and from the Medical Birth Register in the first trimester (for women). The follow-up period started in 2005 and continued until 2012. Age-standardized cumulative incidence rates (CR) of bariatric surgery were compared between different BMI groups by considering individual variables. We analyzed the association between the individual variables and bariatric surgery using Cox proportional hazard models. Results: In the study population of 814,703 women and 787,027 men, a total of 7433 women and 1961 men underwent bariatric surgery. In women, the hazard ratios (HRs) for bariatric surgery were higher for low and middle income and educational levels, compared to high income and educational levels. In men, the highest HR for bariatric surgery was found among those with a high income. The HRs when comparing the different socioeconomic groups in those with BMI > 40 kg/m 2 showed no significant results, except for middle education in women. Conclusion:Differences in bariatric surgery between socioeconomic groups were found, favoring those with a low socioeconomic status. However, very few socioeconomic differences were found amongst those who had a BMI > 40 kg/m 2 . This indicates that the Swedish healthcare system seems to have achieved equal access to health care for bariatric surgery.

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“…Lastly, we have only studied the influence of deprivation on patients included in a medical program for obesity and did not analyze if deprivation changes access to bariatric surgery in these patients. Therefore, socioeconomic deprivation has been recently shown to be a significant barrier in the choice of bariatric surgery [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Lifestyle intervention program in deprived obese adult patients and their non-deprived counterparts

et al. 2017

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IntroductionAlthough it is known that the prevalence of obesity is high in deprived patients, the link between deprivation and obesity, and the impact of deprivation on compliance and efficacy of a lifestyle intervention program are not known.Materials and methodsDeprivation was assessed in 40 patients (23 Females, mean±SD age: 49±17 years) from the diabetology department and 140 patients (101 Females, age: 50±15 years) from the nutrition department of Bordeaux University hospital. Eighty-seven patients suffering from obesity were evaluated before and after a tailored, multidisciplinary lifestyle intervention. Deprivation was assessed using EPICES scores. Deprivation was defined with an EPICES score > 30.ResultsDeprived patients suffering from obesity had significantly higher current (43.8 ±8.4 versus 40.9 ± 5.5 kg/m2, p = 0,02) and maximal BMI (46.1± 8.6 versus 42.3± 5.2 kg/m2, p = 0.002) compared to non-deprived obese. Percentage of body weight loss was not different according to deprivation (4.74 ± 0.75 versus 4.65 ± 1.04%, p = 0.9). EPICES scores were not different according to adherence to lifestyle intervention program (20.5 ± 8.5 versus 29.9 ± 3.9 versus 29.0 ±2.5, no follow up versus partial follow up versus total follow up, p = 0,58).ConclusionDeprived patients suffering from obesity have a more serious disease than non-deprived patients. However, neither compliance to the lifestyle intervention program nor body weight loss differed between deprived patients with obesity and non-deprived ones. Deprivation should not be a limitation when enrolling patients with obesity in lifestyle intervention programs.

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Socioeconomic deprivation remains a significant barrier in the choice of bariatric surgery even when full medical expense coverage is present

Cited by 16 publications

References 21 publications

Social deprivation and stroke severity on admission: a French cohort study in Burgundy and the West Indies – Guyana region

Social deprivation and stroke severity on admission: a French cohort study in Burgundy and the West Indies – Guyana region

Socioeconomic factors, body mass index and bariatric surgery: a Swedish nationwide cohort study

Lifestyle intervention program in deprived obese adult patients and their non-deprived counterparts

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