Patients’ Acceptance of Prioritization for Bariatric SurgeryThursday, February 6, 2014
As regular readers are well aware, bariatric surgery is still rather hard to come by in most Canadian provinces.
This prompted us to examine patients’ perspectives on wait-list prioritization and willingness to pay for bariatric surgery amongst patients waiting for surgery in our program.
The paper by Richdeep Gill and colleagues, published in the Canadian Journal of Surgery, examines the responses of wait-listed patients to nine hypothetical scenarios describing patients waiting for surgery.
Respondents were asked to rank the priority of these hypothetical patients on the wait list relative to their own.
Scenarios examined variations in age, clinical severity, functional impairment, social dependence and socioeconomic status. We also assessed willingness to pay for faster access using a 5-point ordinal scale.
Overall respondents assigned similar priority to hypothetical patients with characteristics similar to their own but higher priority (greater urgency) to those exhibiting greater clinical severity and functional impairment.
On the other hand, they assigned lower priorities to patients at the extremes of age, on social assistance, or of of higher socioeconomic status.
Most (85%) respondents disagreed with payment to expedite access, although participants earning more than $80 000/year were less likely to disagree.
These findings show that most patients waiting for bariatric surgery are OK with prioritization of patients with greater clinical severity and functional impairments but generally disagree with paying for faster access.
Thus, these findings certainly suggest that there would be general acceptance of giving priority to patients with higher Edmonton Obesity Stages, even if this would mean longer waits for themselves.
How Canadian is that?
Gill RS, Majumdar SR, Wang X, Tuepah R, Klarenbach SW, Birch DW, Karmali S, Sharma AM, & Padwal RS (2014). Prioritization and willingness to pay for bariatric surgery: the patient perspective. Canadian journal of surgery. Journal canadien de chirurgie, 57 (1), 33-9 PMID: 24461224
Thursday, February 6, 2014
Based on the reality that more and more Canadians are either going to Quebec or leaving the country for self-pay bariatric surgery I’m inclined to think that this study doesn’t reflect the general population.
Friday, February 7, 2014
I was part of this program, and although I had to wait three years to get in, I found that it took almost that long for all the help I got to sink in and for me to do the research I needed about this surgery. In fact, I am still learning things that I should have known prior. Such as the difficulty in absorbing iron. I knew I was going to take supplements for the rest of my life but was unaware that I would require iron infusions just to keep a low normal iron in my system. Now this would not have changed my decision as it was the best decision of my life. However, I know that the faster the waiting list gets the more impulsive the decision will be. We have impulse control issues as a general rule, so if I had not been on a waiting list I would have been like thousands in the states…… do it with in a couple of weeks after my decision, and not even have a clue what to eat the following very important weeks. \
\just my humble opinion. By the way I lost over 270 lbs and am soooo happy about my life now.