在英格兰使用初级和中等保健的常规数据 (2007-2020) 获得公开资助的体重管理服务:一项观察性队列研究
Karen D Coulman1,2,3, Ruta Margelyte4,5, Tim Jones1,4,5
1Health Economics Bristol, Population Health Sciences, University of Bristol, Bristol, United Kingdom.
PLoS medicine
|September 28, 2023
概括
一小部分符合条件的成年人接受了体重管理 (WM) 转诊或减肥手术. 较高的身体质量指数 (BMI) 和GP实践区域强烈影响了获得这些肥胖治疗的机会.
科学领域:
- 公共卫生 公共卫生
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 国家指南支持公共资助的超重/肥胖成年人体重管理 (WM) 计划.
- 减肥手术可用于严重和复杂的肥胖症患者.
- 初级保健对于识别和转诊患者进行医疗保健干预至关重要.
研究的目的:
- 为了描述英格兰的初级保健人口,引用了WM干预措施.
- 描述英格兰接受减肥手术的初级保健人口.
- 为了确定与WM转诊和减肥手术相关的患者和GP实践特征.
主要方法:
- 使用初级保健数据的观察性队列研究 (临床实践研究数据链接) 与医院病例统计数据 (英格兰,2007-2020年) 相联系.
- 纳入标准:有1,811,587名成年人有过重/肥胖记录.
- 多变量波桑回归分析了人口统计,临床和区域因素与WM转诊和减肥手术的关联.
主要成果:
- 只有3.13%的符合条件的成年人被转介给WM,1.09%的严重/复杂肥胖患者接受了减肥手术.
- 较高的体重指数 (BMI) 与WM转诊 (RR 6.19 BMI ≥40 kg/m2) 和减肥手术 (RR 5.52 BMI 35.0-40.0 kg/m2 与并发症) 的可能性增加密切相关.
- 在获得WM转诊和减肥手术方面观察到显著的区域差异,更高的BMI和增加的并发症强烈预测了减肥手术.
结论:
- 在2007年至2020年期间,很少有符合条件的成年人接受了WM转诊或减肥手术.
- 较高的BMI和GP实践地区是这两种结果的最强预测因素,这表明服务提供方面存在潜在的区域不平等.
- 除了预防策略外,更好地获得WM干预措施对于降低肥胖水平至关重要.
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