❓ Question regarding the justification for the age cutoff of 55 years for bariatric surgery in WA, and the response details the evidence-based approach, alternative treatments, and patient statistics.
AnsweredQoN 447Legislative Assembly
QuestionView source ↗
I refer to the Government’s standardised access criteria for patients to be considered for Bariatric Surgery in WA and ask: (a) what is the justification for the 55 years of age cutoff date for bariatric surgery; (b) is there any medical evidence for this age cutoff and if so, what is that evidence; (c) what are the alternative treatments available to people who are over the 55 years cutoff date; (d) what number of patients over the age of 55 have received or are scheduled to receive bariatric surgery; and (e) how many patients, who would otherwise be eligible, have been refused bariatric surgery as a result of being older than 55 years?
AnswerView source ↗
Answered
1 August 2013
Responded by
Minister for Health
Response time
51 days
(a) Following on from the WA Health Morbid Obesity Model of Care (May 2008) WA developed the
WA Health Bariatric Surgery Plan - a standardised approach to surgery for obesity (October 2012)
that includes clinical access criteria on which to assess the appropriateness of public patients for bariatric surgery. The criteria are standardised according to national and international evidence-based best practice. This standardisation covers a range of areas including age, body weight, associated co-morbidities and psychological evaluation to carefully consider the benefits and risks and ensure that patient safety and quality are at the forefront of decision making.
(b) WA Health undertook extensive literature research and consultation with medical and surgical experts to determine the access criteria for public patients. Consultation with bariatric surgeons in WA resulted in the adaptation of assessment criteria from NSW Health (Obesity Management Plan, NSW Health 2009), and aligns with approaches taken in other jurisdictions nationally.
(c) Bariatric surgery is an option of last resort for morbidly obese patients as the surgery is not without risks. Individuals who do not qualify for publically funded bariatric surgery under the new criteria should continue to be managed by their general practitioner who will be able to provide referral to a range of multidisciplinary, Medicare-billable health services such as access to dieticians, exercise physiologists, psychologists and podiatrists.
(d) The following table shows the number of WA patients aged over 55 years that have been admitted for bariatric surgery, by year since 2010.
Admission Year
Number of WA patients
2010
59
2011
67
2012
67
2013 YTD
26
As at 16 June 2013, there are 21 patients in WA aged over 55 years that are on list awaiting bariatric surgery.
(e) Public patients who were already referred onto the elective surgery waiting list were not affected by the new clinical access criteria. Only new patients assessed by a specialist after 26 November 2012 will be assessed against the new clinical access criteria.
At Sir Charles Gairdner Hospital, 317 patients, who have been referred for a public outpatient appointment, are over 55 years of age and are therefore being advised that they are not eligible under the clinical access criteria. However, it should be noted that regardless of age, there can be other factors that may preclude patients from being suitable for surgery.
WA Health Bariatric Surgery Plan - a standardised approach to surgery for obesity (October 2012)
that includes clinical access criteria on which to assess the appropriateness of public patients for bariatric surgery. The criteria are standardised according to national and international evidence-based best practice. This standardisation covers a range of areas including age, body weight, associated co-morbidities and psychological evaluation to carefully consider the benefits and risks and ensure that patient safety and quality are at the forefront of decision making.
(b) WA Health undertook extensive literature research and consultation with medical and surgical experts to determine the access criteria for public patients. Consultation with bariatric surgeons in WA resulted in the adaptation of assessment criteria from NSW Health (Obesity Management Plan, NSW Health 2009), and aligns with approaches taken in other jurisdictions nationally.
(c) Bariatric surgery is an option of last resort for morbidly obese patients as the surgery is not without risks. Individuals who do not qualify for publically funded bariatric surgery under the new criteria should continue to be managed by their general practitioner who will be able to provide referral to a range of multidisciplinary, Medicare-billable health services such as access to dieticians, exercise physiologists, psychologists and podiatrists.
(d) The following table shows the number of WA patients aged over 55 years that have been admitted for bariatric surgery, by year since 2010.
Admission Year
Number of WA patients
2010
59
2011
67
2012
67
2013 YTD
26
As at 16 June 2013, there are 21 patients in WA aged over 55 years that are on list awaiting bariatric surgery.
(e) Public patients who were already referred onto the elective surgery waiting list were not affected by the new clinical access criteria. Only new patients assessed by a specialist after 26 November 2012 will be assessed against the new clinical access criteria.
At Sir Charles Gairdner Hospital, 317 patients, who have been referred for a public outpatient appointment, are over 55 years of age and are therefore being advised that they are not eligible under the clinical access criteria. However, it should be noted that regardless of age, there can be other factors that may preclude patients from being suitable for surgery.
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