Latest AHHA-published research shows under-capacity in bariatric surgery, differences in patient safety culture in hospitals

Friday, August 3, 2018

‘Research published in the August issue of Australian Health Review shows that we may have an under-capacity problem in bariatric surgery’, according to the AHR’s Editor in Chief, Professor Gary Day.

AHR is the Australian Healthcare and Hospitals Association’s peer-reviewed academic journal. The August 2018 issue is now available online.

‘The research team from the Menzies Institute of Medical Research in Hobart found that around 900,000 obese Australians—about one-quarter of all those who are obese—were potentially eligible for bariatric surgery.

‘Bariatric surgery—which includes gastric band, gastric sleeve and gastric bypass procedures—is considered to be cost-effective and is in fact the most effective treatment for adults with obesity.

‘But even if only 5% of people potentially eligible for these procedures—or around 45,000 people—took up this surgical solution, the demand would seriously outstrip current capacity, especially in the public health system and outside the major cities’, Professor Day said.

‘Details of how many bariatric procedures are performed annually in Australia, and what the demand is, are not easy to come by. But we do know that in the private healthcare system, where about 90% of bariatric surgery occurs, there were 16,650 procedures undertaken in 2015.

‘Given the discrepancies and the potential demand, more attention needs to be given to how to prioritise patients for bariatric surgery. And, given that obesity is more prevalent in the most disadvantaged groups, the study sends a strong signal that more public funding of bariatric surgery is needed.’

Another article published in the August AHR relates to patient safety in hospitals. Various studies have shown that the stronger the safety culture, the fewer mistakes are made.

A two-person research team from the School of Nursing, Midwifery and Paramedicine at Curtin University in Perth decided to look into this issue further to see how patient safety was viewed within hospitals, whether it was different at hospital vs ward level, and whether clinicians and managers place the same importance on it.

‘The results were a surprise in that they did not vary globally’, Prof. Day said.

‘Doctors tend to have a poorer perception of patient safety than nurses or allied health professionals. All health professionals report a more positive view of ward safety culture than hospital safety culture. And managers of health professionals reported more positively on safety culture than bedside clinicians.

‘The message for hospitals is that training needs to encourage a shared vision of patient safety across all groups of staff.’

‘Another article highlighted differences in regulatory models for medicinal cannabis. The author team from the National Alcohol and Drug Research Centre at the University of New South Wales showed the variety of ways in the world that medicinal cannabis is legally supplied, and how patients are authorised to use it. Optimal policies will depend on the overall goals of the policy, and this article is a good source of all the different options’, Prof. Day said.

‘Finally, I’d like to draw attention to a highly technical study of two Aboriginal Community-Controlled Health Services that examined the way data are extracted from a database for national performance reporting. The study showed that although data extraction methods were accurate, the data included past patients and deceased patients, leading to under-reporting of the performances of the medical services’, Professor Day said.

Articles from the June 2018 AHR can be found here. Some are freely available through open access, while others need a subscription or can be purchased individually.

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, Primary Health Networks, and community and primary healthcare services.

Media enquiries:  Prof Gary Day, Editor in Chief, Australian Health Review

0422 236 571