Clinical Obesity Services in Public Hospitals in Australia: a position statement based on expert consensus

被引：36

作者：

Atlantis, E. ^{[1
,2
,3
]}

Kormas, N. ^{[4
,5
,6
]}

Samaras, K. ^{[7
,8
]}

Fahey, P. ^{[9
]}

Sumithran, P. ^{[10
,11
]}

Glastras, S. ^{[12
]}

Wittert, G. ^{[3
]}

Fusco, K. ^{[3
]}

Bishay, R. ^{[13
]}

Markovic, T. ^{[14
,15
]}

Ding, L. ^{[12
,16
]}

Williams, K. ^{[17
,18
,19
]}

Caterson, I. ^{[14
,15
]}

Chikani, V. ^{[20
]}

Dugdale, P. ^{[21
,22
]}

Dixon, J. ^{[23
,24
]}

机构：

[1] Western Sydney Univ, Sch Nursing & Midwifery, Campbelltown Campus,Locked Bag 1797, Penrith, NSW 2751, Australia

[2] Capital Markets Cooperat Res Ctr, Sydney, NSW, Australia

[3] Univ Adelaide, Sch Med, Adelaide, SA, Australia

[4] Concord Repatriat Gen Hosp, Dept Endocrinol & Metab, Sydney, NSW, Australia

[5] Campbelltown & Camden Hosp, Dept Endocrinol, Sydney, NSW, Australia

[6] Campbelltown Hosp, Diabetes Obes Metab Translat Res Unit, Sydney, NSW, Australia

[7] St Vincents Hosp, Dept Endocrinol, Sydney, NSW, Australia

[8] Garvan Inst Med Res, Diabetes & Metab Div, Sydney, NSW, Australia

[9] Western Sydney Univ, Sch Sci & Hlth, Penrith, NSW, Australia

[10] Austin Hlth Weight Control Clin, Heidelberg, Vic, Australia

[11] Univ Melbourne, Dept Med Austin Hlth, Heidelberg, Vic, Australia

[12] Royal North Shore Hosp, Dept Endocrinol Diabet & Metab, St Leonards, NSW, Australia

[13] Western Sydney Univ, Blacktown Hosp, Metabol & Weight Loss Clin, Univ Clin, Sydney, NSW, Australia

[14] Univ Sydney, Charles Perkins Ctr, Boden Inst, Sydney, NSW, Australia

[15] Royal Prince Alfred Hosp, Metabolism & Obes Serv, Camperdown, NSW, Australia

[16] Royal North Shore Hosp, Dept Chem Pathol, NSW Hlth Pathol, Sydney, NSW, Australia

[17] Sydney Med Sch Nepean, Sydney, NSW, Australia

[18] Nepean Blue Mountains Local Hlth Dist, Nepean Family Obes Serv, Sydney, NSW, Australia

[19] Nepean Blue Mountains Local Hlth Dist, Nepean Family Obes Serv, Sydney, NSW, Australia

[20] Princess Alexandra Hosp, Dept Diabet & Endocrinol, Brisbane, Qld, Australia

[21] Australian Natl Univ, Ctr Hlth Stewardship, Canberra, ACT, Australia

[22] Australian Capital Terr Hlth Directorate, Chron Dis Management Unit, Canberra, ACT, Australia

[23] Baker Heart & Diabet Inst, Melbourne, Vic, Australia

[24] Swinburne Univ Technol, Iverson Hlth Innovat Res Inst, Hawthorn, Vic, Australia

来源：

CLINICAL OBESITY | 2018年 / 8卷 / 03期

关键词：

Obesity; hospital Outpatient Clinics; specialist weight management; weight loss;

D O I：

10.1111/cob.12249

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We aimed to describe the current state of specialist obesity services for adults with clinically severe obesity in public hospitals in Australia, and to analyse the gap in resources based on expert consensus. We conducted two surveys to collect information about current and required specialist obesity services and resources using open-ended questionnaires. Organizational level data were sought from clinician expert representatives of specialist obesity services across Australia in 2017. Fifteen of 16 representatives of current services in New South Wales (n = 8), Queensland (n = 1), Victoria (n = 2), South Australia (n = 3), and the Australian Capital Territory (n = 1) provided data. The composition of services varied substantially between hospitals, and patient access to services and effective treatments were limited by strict entry criteria (e.g. body mass index 40kg/m(2) or higher with specific complication/s), prolonged wait times, geographical location (major cities only) and out-of-pocket costs. Of these services, 47% had a multidisciplinary team (MDT), 53% had an exercise physiologist/physiotherapist, 53% had a bariatric surgeon and 33% had pharmacotherapy resources. Key gaps included staffing components of the MDT (psychologist, exercise physiologist/physiotherapist) and access to publicly funded weight loss pharmacotherapy and bariatric surgery. There was consensus on the need for significant improvements in staff, physical infrastructure, access to services, education/training in obesity medicine and targeted research funding. Based on the small number of existing, often under-resourced specialist obesity services that are located only in a few major cities, the vast majority of Australians with clinically severe obesity cannot access the specialist evidence based treatments needed.

引用

页码：203 / 210

页数：8

共 28 条

[1]

[Anonymous], 2009, SURG MORB OB FRAM BA

[2]

Australian Bureau of Statistics, 2017, 3101 0 AUSTR DEM STA

[3]

Australian Diabetes Society Australian and New Zealand Obesity Society Obesity Surgery Society of Australian and New Zealand, 2017, AUSTR OB MAN ALG AUS

[4]

Australian Institute of Health and Welfare, 2017, WEIGHT LOSS SURG AUS

[5] Workforce capacity to address obesity: a Western Australian cross-sectional study identifies the gap between health priority and human resources needed [J].