A Comprehensive Insight into the Economic Profile of People Receiving Metabolic and Bariatric Surgery Use in France

Abstract

Background: The use of metabolic and bariatric surgery (MBS) is not uniformly distributed within the population, even if it is governed by established guidelines. This disparity seems to be associated, among other factors, with the economic profile of people receiving this surgery.

Objectives: We investigated the disparities in the use of MBS with respect to the socio-economic level in France based on socio-economic status (SES).

Materials and methods: A descriptive observational study was conducted to compare the population of individuals with obesity who underwent MBS (MBS group) with individuals with obesity with no history of MBS (obese group). Data were extracted from the French National Hospital discharge database ("Programme De Médicalisation des Systèmes d'Information," PMSI). Socio-economic status (SES) was assessed through the French Deprivation Index (FDep).

Results: The use of MBS was significantly lower in patients having a higher SES compared to those having a lower one. There was no statistically significant difference in the use of MBS between individuals within the 4th and 5th SES quintiles compared to those in the 2nd and 3rd quintiles. No difference was found in the specific MBS procedures used depending on the SES. The obesity level was significantly lower in patients from the 1st and 3rd SES quintiles compared to the patients having a lower SES.

Conclusion: Our study provides valuable insights into the complex interrelationships between the use of MBS, patients' SES, and obesity levels according to the FDep. These findings underscore the importance of developing targeted interventions to address disparities in the use of bariatric care.

Keywords: Adjustable Gastric Banding; Metabolic and Bariatric Surgery; Obesity; Roux-en-Y Gastric Bypass; Sleeve Gastrectomy; Social Deprivation; Social Deprivation Index; Socio-economic Status.