scholarly journals BARIATRIC SURGERY IN BRAZILIAN PUBLIC HEALTH SYSTEM: THE GOOD, THE BAD AND THE UGLY, OR A LONG WAY TO GO. YELLOW SIGN!

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
Antoninho José TONATTO-FILHO ◽  
Felipe Melloto GALLOTTI ◽  
Marcio Fernandes CHEDID ◽  
Tomaz de Jesus Maria GREZZANA-FILHO ◽  
Ana Maria Stapasolla Vargas GARCIA
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Descriptive Analysis ◽  
Age Groups ◽  
Surgical Techniques ◽  
Current Status ◽  
The Public ◽  
Health Registry

ABSTRACT Background: In Brazil, there has been a significant increase in obesity rates in all age groups. Data from 2017 show that obesity affects 19% of the population. Due to the magnitude of the problem, public health policies have aimed to prevent complications related to obesity by increasing the offerfor bariatric surgeries. Aim: To analyze the current status of bariatric surgery performed in the Brazilian public health system, including data from macroregions and also the effect of digestive surgery training on the number of procedures. Methods: The database of the public health registry (DATASUS) was assessedbetween 2008 and 2018 for descriptive analysis of data and evaluation of the selected parameters. The main surgical techniques, comorbidities, mortality and the costs profile of the system were evaluated. Results: There was a 339% increase in the number of bariatric surgeries in the period evaluated. Gastric bypass was performed in 94% of cases whereas sleeve in 2.4%. Other techniques were used in 3.6%. There were discrepancies in the number of surgeries performed in different regions of the country. Conclusion: There was a considerable advance in the number of bariatric surgeries performed by the public health system between 2008 and 2018. However, there is a need to increase the offer of this service and alsospecialized training, as well as a correction in the distribution of these procedures in the national territory to achieve integrality among its users.

scholarly journals Population estimates and characteristics of Australians potentially eligible for bariatric surgery: findings from the 2011–13 Australian Health Survey

2018 ◽  
Vol 42 (4) ◽  
pp. 429 ◽  
Author(s):  
Melanie J. Sharman ◽  
Monique C. Breslin ◽  
Alexandr Kuzminov ◽  
Andrew J. Palmer ◽  
Leigh Blizzard ◽  
...  
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Population Estimates ◽  
Eligibility Criteria ◽  
The Public ◽  
Australian Health ◽  
Potential Demand ◽  
Patient Prioritisation

Objective The aim of the present study was to determine the potential demand for publicly and privately funded bariatric surgery in Australia. Methods Nationally representative data from the 2011–13 Australian Health Survey were used to estimate the numbers and characteristics of Australians meeting specific eligibility criteria as recommended in National Health and Medical Research Council guidelines for the management of overweight and obesity. Results Of the 3 352 037 adult Australians (aged 18–65 years) estimated to be obese in 2011–13, 882 441 (26.3%; 95% confidence interval (CI) 23.0–29.6) were potentially eligible for bariatric surgery (accounting for 6.2% (95% CI 5.4–7.1) of the adult population aged 18–65 years (n = 14 122 020)). Of these, 396 856 (45.0%; 95% CI 40.4–49.5) had Class 3 obesity (body mass index (BMI) ≥40 kg m–2), 470945 (53.4%; 95% CI 49.0–57.7) had Class 2 obesity (BMI 35–39.9 kg m–2) with obesity-related comorbidities or risk factors and 14 640 (1.7%; 95% CI 0.6–2.7) had Class 1 obesity (BMI 30–34.9 kg m–2) with poorly controlled type 2 diabetes and increased cardiovascular risk; 458 869 (52.0%; 95% CI 46.4–57.6) were female, 404 594 (45.8%; 95% CI 37.3–54.4) had no private health insurance and 309 983 (35.1%; 95% CI 28.8–41.4) resided outside a major city. Conclusion Even if only 5% of Australian adults estimated to be eligible for bariatric surgery sought this intervention, the demand, particularly in the public health system and outside major cities, would far outstrip current capacity. Better guidance on patient prioritisation and greater resourcing of public surgery are needed. What is known about this topic? In the period 2011–13, 4 million Australian adults were estimated to be obese, with obesity disproportionately more prevalent in areas of socioeconomic disadvantage. Bariatric surgery is considered to be cost-effective and the most effective treatment for adults with obesity, but is mainly privately funded in Australia (>90%), with 16 650 primary privately funded procedures performed in 2015. The extent to which the supply of bariatric surgery is falling short of demand in Australia is unknown. What does this paper add? The present study provides important information for health service planners. For the first time, population estimates and characteristics of those potentially eligible for bariatric surgery in Australia have been described based on the best available evidence, using categories that best approximate the national recommended eligibility criteria. What are the implications for practitioners? Even if only 5% of those estimated to be potentially eligible for bariatric surgery in Australia sought a surgical pathway (44 122 of 882 441), the potential demand, particularly in the public health system and outside major cities, would still far outstrip current capacity, underscoring the immediate need for better guidance on patient prioritisation. The findings of the present study provide a strong signal that more funding of public surgery and other effective interventions to assist this population group are necessary.

scholarly journals Path taken by morbidly obese people in search of bariatric surgery in the public health system

2020 ◽  
Vol 28 ◽  
Author(s):  
Claudete Aparecida Conz ◽  
Maria Cristina Pinto de Jesus ◽  
Estela Kortchmar ◽  
Vanessa Augusta Souza Braga ◽  
Renata Evangelista Tavares Machado ◽  
...  
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Professional Training ◽  
Social Inequalities ◽  
Public Health System ◽  
Morbidly Obese ◽  
Obese People ◽  
The Public ◽  
The Social

Objective: to understand the path taken in the public health system by people with morbid obesity in the search for bariatric surgery. Method: qualitative research based on the social phenomenology of Alfred Schütz, with 17 hospitalized morbidly obese people, with a scheduled date for bariatric surgery. The phenomenological interview with open questions was used and the statements were analyzed in the light of the theoretical-methodological framework and literature related to the theme. Results: the participants were able to schedule bariatric surgery by referring friends, family and public people. The waiting list for the procedure generated anguish and anxiety due to fear of surgery, weight gain, risk of worsening health and physical limitations, but it helped prepare for its performance. The experience lived in the search for bariatric surgery led these people to want continuity of care in the Basic Health Unit, after the surgery, by professionals trained to meet their needs. Conclusion: the aspects inscribed in the path of people in search of bariatric surgery signal the need to strengthen the assistance-related flows of the public health system and to invest in professional training to reduce the social inequalities in access to bariatric surgery and increased quality of services.

Post–Bariatric Surgery Body Contouring Treatment in the Public Health System

2014 ◽  
Vol 134 (3) ◽  
pp. 448-454 ◽  
Author(s):  
Jordi Vilà Poyatos ◽  
José María Balibrea del Castillo ◽  
Benjamí Oller Sales ◽  
Antonio Alastrué Vidal
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Body Contouring ◽  
The Public ◽  
Post Bariatric Surgery

scholarly journals Assessment of dependence and anxiety among benzodiazepine users in a provincial municipality in Rio Grande do Sul, Brazil

2016 ◽  
Vol 38 (2) ◽  
pp. 63-70 ◽  
Author(s):  
Janaína Barden Schallemberger ◽  
Christiane de Fátima Colet
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Age Groups ◽  
Self Report ◽  
Cross Sectional ◽  
The Public ◽  
Inappropriate Use ◽  
Benzodiazepine Use ◽  
Severe Degree

Abstract Introduction: Benzodiazepines are among the most prescribed drugs for anxiety and one of the most used drug classes in the world and have a high potential for addiction. The objective of this study was to assess levels of dependence and anxiety among users of these drugs in the public health system. Methods: This was a cross-sectional, descriptive and quantitative study. Benzodiazepine users treated on the public health system were selected. Anxiety levels were assessed with the Hamilton Anxiety Scale and dependency with the Benzodiazepine Dependence Self-Report Questionnaire. Results: Benzodiazepine use was higher among women and in older age groups. Duration of benzodiazepine use was greater than 1 year for all respondents. The dependence assessment indicated that more than half of users were dependent on taking benzodiazepines and most had a severe degree of anxiety. Conclusion: This study found evidence of prolonged and inappropriate use of benzodiazepines. It is necessary to educate users about the risks of these drugs and to develop strategies to rationalize use of these drugs by working with prescribers and dispensers.

Descriptive Analysis of the Economic Costs of Periprosthetic Joint Infection of the Knee for the Public Health System of Andalusia

2013 ◽  
Vol 28 (7) ◽  
pp. 1057-1060 ◽  
Author(s):  
J. Garrido-Gómez ◽  
M.A. Arrabal-Polo ◽  
M.S. Girón-Prieto ◽  
J. Cabello-Salas ◽  
J. Torres-Barroso ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Periprosthetic Joint Infection ◽  
Public Health System ◽  
Joint Infection ◽  
Descriptive Analysis ◽  
Economic Costs ◽  
The Public

scholarly journals Endovascular correction of isolated descending thoracic aortic disease: a descriptive analysis of 1,344 procedures over 10 years in the public health system of São Paulo

Clinics ◽  
2021 ◽  
Vol 76 ◽  
Author(s):  
Maria Fernanda Cassino Portugal ◽  
Marcelo Passos Teivelis ◽  
Marcelo Fiorelli Alexandrino da Silva ◽  
Nickolas Stabellini ◽  
Alexandre Fioranelli ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Descriptive Analysis ◽  
Aortic Disease ◽  
Sao Paulo ◽  
São Paulo ◽  
Thoracic Aortic Disease ◽  
The Public

scholarly journals Randomized controlled trial protocol: A quanti-quali approach for analyzing the results of an intervention on the waiting list for bariatric surgery

2019 ◽  
Vol 32 ◽  
Author(s):  
Mayara Martins EVANGELISTA ◽  
Alex Harley CRISP ◽  
Sinara Laurini ROSSATO ◽  
Carla Maria VIEIRA ◽  
Rayli BOSSA ◽  
...  
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Clinical Trial ◽  
Health System ◽  
Educational Intervention ◽  
Public Health System ◽  
Intervention Group ◽  
Waiting List ◽  
Control Group ◽  
The Public

ABSTRACT Objective This article aims to describe the protocol of a randomized clinical trial and the baseline results of the study of a one-year interdisciplinary intervention in users of the public health system in the bariatric surgery waiting list. Methods A randomized, single-blind clinical trial will be conducted including 88 participants recruited on an outpatient clinic of the public health system. Participants were randomized into the control group (n=44), receiving the usual treatment; and into the intervention group (n=44), participating in the educational intervention. Participants had their food intake, negative affectivity and physical inactivity/sedentary behavior assessed, as well as anthropometric and body composition measurements; their blood samples were collected; and also had different physical capacity tests. Results Of the 157 participants invited, 27 had severe functional limitations, one was under-age, and four declined the study due to associated diseases. Eighty-eight participants were randomized: 44 for the Control Group and 44 for the Intervention Group. When comparing the demographic and biochemical characteristics, there were no differences between groups except for serum glucose (GC=110.4±46.8mg/dL and GI93.1±16.9mg/dL, p=0.039). Conclusion This study protocol describes the methodology used in the study of educational intervention for the promotion of health care of patients on the waiting list for bariatric surgery. It shows that there is similarity between the baseline comparison groups. Registro Brasileiro de Ensaios Clínicos (Brazilian Clinical Trials Registry), RBR-775y3d.

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