Background:
Increased demand for bariatric surgery creates prolonged wait-list times, and increases burden on public healthcare. The long-term influence of bariatric surgery on hospital admissions and emergency department (ED) presentations is under-investigated.
Aims:
To determine public hospital services utilisation (hospital admissions, ED presentations) in patients wait-listed for bariatric surgery before and after surgery or wait-list removal, and to identify hospital admission reasons associated with drop-out.
Methods:
All Tasmanians waiting for publicly-funded primary bariatric surgery from 2008 to 2013, their hospital admissions and ED presentations episodes were identified and extracted using administrative datasets. Episodes were assigned to 3 periods: before wait-list, while waiting, and after a bariatric operation or drop-out.
Results:
648 wait-listed patients had 3,161 public hospital admissions in 2006-2014 and 4,928 ED presentations in 2000-2014.
During the wait-list period, the hospital admission rate differed significantly between operated and dropped-out patients (44.9 vs 64.2 per 100 person-years, p<0.01). Mental health problems, poisonings, injuries and renal disorders while on the wait-list were associated with drop-out.
Hospital admission rates increased post-surgery (from 44.9 to 64.2 per 100 person-years, p<0.01). Operated patients presented to the ED more frequently than dropped-out patients in the post-wait-list period (78.9 vs 60.1 per 100 person-years, p<0.05). The likelihood of being admitted from the ED increased after the operation from 31.6% to 39.1% (p<0.05) of presentations.
Conclusions:
Certain conditions were associated with wait-list drop-out. While bariatric surgery has many health benefits, it was not associated with fewer hospital admissions or ED presentations in the Tasmanian public hospital system.