title: Review of Publicly-Funded Bariatric Surgery Policy in Australia-Lessons for More Comprehensive Policy Making.
abstract: BACKGROUND
  The objective of the study was to determine the level of guidance provided by or to government health departments across different regions of Australia on publicly funded bariatric surgery.
  
  
  METHODS
  Bariatric surgery policies and guidelines were sought from each Australian state (n = 6) and territory (n = 2) government health department and compared in relation to their origins, level of guidance on patient eligibility and priority, as well as recommendations for patient care, including follow-up surgical services. Comparison with national guidelines on bariatric surgery from Australia, the UK and USA was also made.
  
  
  RESULTS
  Five of the eight states and territories had policies or guidelines informing practice. There was little uniformity among regional guidelines and variable consistency with national guidelines (e.g., defining obesity related comorbidity). Recommendations differed on patient eligibility, and none of the state documents mentioned re-operative bariatric or body-contouring surgery. There was limited guidance on prioritisation of eligible patients and gastric banding adjustments. Pre- and post-surgical multidisciplinary care was generally recommended.
  
  
  CONCLUSIONS
  Policies and guidelines on publicly funded bariatric surgery are highly variable across Australia and at times inconsistent with national guidelines. Insufficient guidance exists regarding the prioritisation of eligible patients and follow-up surgical services. These findings have implications for policy, research and practice and are particularly important in health service environments with resource constraints and inequitable patient access to services.
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Sharman
authors.affiliation: Department of Health and Human Services, Hobart, TAS, Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Hensher
authors.affiliation: Department of Health and Human Services, Hobart, TAS, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wilkinson
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Campbell
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia. Alison.venn@utas.edu.au.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Venn
mesh_terms: D001315:Australia; D050110:Bariatric Surgery / Q000191:economics*; D006291:Health Policy; D006801:Humans; D009313:National Health Programs
keywords: Bariatric surgery; Health policy; Health services; Metabolic surgery; Obesity