Potential demand for obesity surgery: Findings from Turkish health survey

Objective: The main objective of this study is to identify potential 
demand for obesity surgery funded by public and private health 
insurance in Turkey. Method: Negative Binomial Regression (NBR) 
analysis was used to answer the question of “Do age, gender, being 
under the umbrella of social security, having an illness in the last 6 
months and being included in one of the obesity groups affect the 
number of health services received?”. The NBR model, used when the 
dependent variable has a counting number, is a technique that works 
better than Poisson regression if the data has excessive distribution. 
In addition, the number of services received was subjected to analysis 
of differences according to subcategories of independent variables. 
The variables used in the analysis were obtained from the “Turkey 
Statistical Institute (TURKSTAT) - TÜİK Health Survey” micro dataset 
for 2016 and 2019. Results: Variables that positively affect the number 
of health services received are included in Class 1, Class 2, Class 3 
obesity group and are gender, having social security, having illness in 
the last 6 months and diabetes (p<0,05). The presence of diabetes in 
a person increases the number of services receiving 1.42 times, being 
a woman 1.49 times, having any illness in the last six months 2.04 
times and having a social security umbrella 1.14 times. Also, being in 
the Class I group affects the number of services receiving 1.28 times, 
Class II affects 1.57 times and Class III affects 1.93 times. Conclusion: 
When only 5% of Turkish adults, who are estimated to be suitable for 
bariatric surgery, want to be treated, the health system will be unable 
to respond to demand. There needs to be better guidance on patient 
prioritization and more resources for public surgical planning.