Attrition after Acceptance onto a Publicly Funded Bariatric Surgery Program.

Area of Science:

• Obesity research
• Surgical outcomes
• Health equity

Background:

• Bariatric surgery programs face challenges with patient attrition.
• New Zealand has high obesity rates, particularly among Pacific and Māori populations.
• These ethnic groups experience poorer health outcomes, increasing their need for bariatric interventions.

Purpose of the Study:

• To investigate factors influencing attrition from publicly funded bariatric surgery programs in New Zealand.
• To compare demographic and clinical features of patients who completed surgery versus those who dropped out.
• To identify specific factors associated with pre-surgical attrition.

Main Methods:

• Retrospective cross-sectional study of 704 patients referred for bariatric surgery (2007-2016).
• Comparison of patient characteristics between successful surgery completers (n=326) and dropouts (n=378).
• Logistic regression analysis to identify predictors of attrition.

Main Results:

• Overall attrition rate was 54%, with significant disparities by gender (66% men vs. 45% women) and ethnicity (73% Pacific, 50% Māori, 39% NZ European).
• Attrition was higher for men, Pacific patients, smokers, and individuals with higher BMI.
• Employment was protective against attrition for NZ Europeans but not for Pacific patients.

Conclusions:

• Significant ethnic and gender disparities exist in bariatric surgery program completion.
• Targeted support is crucial for Māori and Pacific individuals, especially men, to complete bariatric surgery.
• Further research into socio-economic and cultural barriers is needed to address attrition.