How many people had surgery for their obesity between 2010 and 2011 in Australia?

With media attention on gastric banding, gastric sleeves and bypass surgery it is easy to assume that the number of people who have surgery to help manage their weight is unusually high. But that’s not the case according to the way I read the Medicare Claim data.

 

You are in a very, very exclusive group if you have had surgery to help manage your weight.

 

Take a look at the claim numbers for July 2010 - June 2011:

 

Medicare Item Number

Type of Surgery

Number claimed

30511

Adjustable gastric band (often called Lapband which is a trade name) and sleeve gastrectomy (also called gastric sleeve)

10,009

30518

Sleeve gastrectomy (for some reason, this can be claimed as one of two item numbers)

1,638

30512

Biliopancreatic bypass diversion (BPD) and Roux en Y gastric bypass (RYGB)

303

TOTAL

 

11,950 claims

 

These numbers don’t include privately funded surgeries that don’t qualify for Medicare Benefit, services provided under the Department of Veterans’ Affairs National Treatment Account, surgeries provided by hospital doctors to pubic patients in public hospitals, and revisions. But it gives a good indication of new claims made in Australia through Medicare.

 

The total of 11,950 claims in a year averages out to about 230 surgeries each week Australia-wide.

 

And if you look at these numbers on a population level, it is only 45 claims per 100,000 population.

 

This is down on previous years with a weekly average of 276 claims being made in 2008-2009.

 

Is this a lot of people having surgery?

 

Not really when the prevalence of morbid obesity is about 1% - 1.7% according to Australian Bureau of Statistics and AusDiab figures from 1999-2000, respectively.

 

Using 1% as the figure and based on a population of close 22,800,000, this suggests that 228,000 people have morbid obesity in Australia.

 

That’s 1000 people in every 100,000 who are morbidly obese.

 

With only 45 claims for banding per 100,000 made through Medicare last financial year, it suggests we’re barely scratching the surface of this massive problem.

 

To operate on all people with morbid obesity in a year, we’d need to see the rate of surgery explode.

 

And if you consider that there are benefits for people with BMI 35 obesity who have other co-morbidities such as diabetes or hypertension, then the numbers being treated need to increase further.

 

Interestingly, more women that men are having surgery yet men out-number women in the obesity numbers.

 

The band requires ongoing maintenance and is not a set and forget device. Maintenance meaning adjustment to find and maintain the sweet spot that appears to be help people control their hunger better.

 

So how many claims for adjustments were made?

 

Medicare Item Number

Type of adjustment

Number claimed

Item 14215

adjustment of gastric band (simple)

128,463

Item 31441

Adjustment of gastric band (anaesthetic)

1638

TOTAL

 

13,0101 claims

 

Substantial behaviour change, adoption of a healthier lifestyle and continued reinforcement and support are also needed and do make a difference to long term outcomes.

 

The dietitian, exercise physiologist, psychologist, nurse, GP, and surgeon are all involved in bariatric surgery yet uncomplicated obesity is not covered under Medicare for dietitians and non-medical health professionals. Medicare claim data for dietitians and other non-medical health professionals is not relevant in relation to obesity surgery.

 

Medicare Claim data available at: https://www.medicareaustralia.gov.au/statistics/mbs_item.shtml

 

I’d love to read your thoughts. Please email me with your comments.