Related Experiment Videos
Prioritization for bariatric surgery: capturing Canadian patient preference weights using a discrete choice
Jennifer Donnan1, Zhiwei Gao2, Tanis Adey2
1School of Pharmacy, Memorial University, St. John's, Newfoundland and Labrador, Canada.
Summary
Patients undergoing bariatric surgery prioritize cardiovascular conditions and daily activity impact when wait times are long. These factors are key for developing fair surgical prioritization systems.
Area of Science:
- Obesity research
- Surgical prioritization
- Patient-centered outcomes
Background:
- Bariatric surgery is a highly effective treatment for obesity.
- High demand for bariatric surgery necessitates a patient prioritization system.
- Current access is often first-come, first-served, leading to long wait times.
Purpose of the Study:
- To quantify patient preferences for attributes used in prioritizing bariatric surgery.
- To inform the development of a fair and effective patient selection process.
- To understand patient values regarding factors influencing surgical need.
Main Methods:
- A Canada-wide discrete choice experiment was conducted with adults with obesity.
- Six key attributes influencing prioritization were identified through focus groups.
- A multinomial logit model analyzed patient preferences from 12 choice tasks.
Main Results:
- Patients prioritized individuals with significant daily activity limitations (OR 4.41) and multiple cardiovascular co-morbidities (OR 4.24).
- Impact on mental health (OR 3.73) and other co-morbidities (OR 3.43) were also significant factors.
- Longer wait times (OR 1.59) and higher body mass index (OR 1.52) showed lower prioritization weight.
Conclusions:
- All studied attributes were important for bariatric surgery prioritization.
- Cardiovascular co-morbidities and impact on daily activities emerged as the most critical factors for patients.
- Patient preferences should guide the development of equitable surgical access policies.