Bariatric equipment and housing adaptations for people with severe obesity in the community: A detailed micro-costing study

Background: Few data exist on bariatric equipment and housing adaptations prescribed by occupational therapists and used by community-dwelling people with severe obesity (PwSO; body mass index (BMI) ⩾ 40 kg/m 2 ). This study aimed to document the use and costs of equipment and home adaptations by community-dwelling PwSO. Methods: An observational, cross-sectional study was conducted with 25 consenting PwSO. During home visits an investigator-administered questionnaire captured use of community equipment and housing adaptations. Local and published sources directed a comprehensive micro-costing. Results: Participants were aged 40–87 years (mean 62 years), BMI 40–77 kg/m 2 (mean 55 kg/m 2 ): 20 were housebound. Nineteen participants (76%) used specialist equipment to accommodate larger body size. The most frequently used equipment were rise-recline chairs. Most chairs ( n = 16, 80%) were heavy duty or custom-made, with a mean cost of £2241, more than double the mean cost of standard chairs £993. Analysis indicated a relationship between increasing BMI category and escalating use and cost of bariatric equipment. Housing adaptations ranged from bathroom grab rails to full-scale house extensions including widened doorways. Wet floor showers were the most common housing adaptation (mean cost £6043). Conclusion: These results highlight areas for further research, staff training and health economic evaluation.