Key result
Public bariatric surgery matches private care for cardiometabolic risk reduction despite higher baseline comorbidities.
Why the study?
Obesity incidence is growing in developing countries, and differences in cardiometabolic risk and physical activity after bariatric surgery between public and private healthcare systems are unclear.
Does bariatric surgery in the public healthcare system compared to the private healthcare system result in different cardiometabolic risk and physical activity outcomes in bariatric patients?
Observational (n=111)
Yes
Does bariatric surgery in the public healthcare system compared to the private healthcare system result in different cardiometabolic risk and physical activity outcomes in bariatric patients?
Bariatric surgery effectively reduces cardiometabolic risk regardless of whether it is performed in a public or private healthcare setting, despite higher baseline comorbidities in public system patients.
Supports equivalent post-bariatric comorbidity reduction across systems; leaves open whether private-system activity differences reflect selection bias or access.
Background: Obesity is a pathology with a growing incidence in developing countries. Objective: To evaluate the evolution of cardiometabolic, anthropometrics, and physical activity parameters in individuals undergoing bariatric surgery (BS) in the public healthcare system (PUS) and private healthcare system (PHS). Methods: A longitudinal, observational, and retrospective study was conducted with 111 bariatric patients on two different health systems, with 60 patients from the PUS and 51 from the PHS. Cardiometabolic risk (CR) was analyzed by the assessment of obesity-related comorbidities (AORC) on admission and 3, 6, and 12 months after BS, and the International Physical Activity Questionnaire (IPAQ) was surveyed before and 12 months after BS. In addition, cardiometabolic risk was also assessed by biochemical (fasting glucose and complete lipidogram) and anthropometric (weight, weight loss, waist circumference, and waist-to-height ratio) parameters. Results: On admission, the parameters of severe obesity, systemic arterial hypertension (SAH), Diabetes mellitus (DM), and waiting time to BS were higher in the PUS. Additionally, in the PUS, AORC was reduced only in the SAH parameter. However, in the post-surgery moment, AORC reduced, and there was no difference between the two groups after BS. Regarding physical activity, the IPAQ showed a higher level of activity in the PHS before and one year after BS. Conclusion: At the PUS, BS is performed in patients with a higher degree of comorbidities, but BS improved the reduction of the CR at a similar level to those observed in the PHS.
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Almeida et al. (2019) conducted an observational in Obesity (n=111). Bariatric surgery in the public healthcare system (PUS) vs. Bariatric surgery in the private healthcare system (PHS) was evaluated on Evolution of cardiometabolic, anthropometrics, and physical activity parameters. Bariatric surgery in the public healthcare system reduced cardiometabolic risk at a similar level to the private healthcare system, despite patients having a higher degree of baseline comorbidities.
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