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Obesity Surgery
Published in: Obesity Surgery 1/2018

01-01-2018 | Original Contributions

The Inequity of Bariatric Surgery: Publicly Insured Patients Undergo Lower Rates of Bariatric Surgery with Worse Outcomes

Authors: Dietric L. Hennings, Maria Baimas-George, Zaid Al-Quarayshi, Rachel Moore, Emad Kandil, Christopher G. DuCoin

Published in: Obesity Surgery | Issue 1/2018

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Abstract

Objective

Bariatric surgery has been shown to be the most effective method of achieving weight loss and alleviating obesity-related comorbidities. Yet, it is not being used equitably. This study seeks to identify if there is a disparity in payer status of patients undergoing bariatric surgery and what factors are associated with this disparity.

Methods

We performed a case-control analysis of National Inpatient Sample. We identified adults with body mass index (BMI) greater than or equal to 25 kg/m2 who underwent bariatric surgery and matched them with overweight inpatient adult controls not undergoing surgery. The sample was analyzed using multivariate logistic regression.

Results

We identified 132,342 cases, in which the majority had private insurance (72.8%). Bariatric patients were significantly more likely to be privately insured than any other payer status; Medicare- and Medicaid-covered patients accounted for a low percentage of cases (Medicare 5.1%, OR 0.33, 95% CI 0.29–0.37, p < 0.001; Medicaid 8.7%, OR 0.21, 95% CI 0.18–0.25, p < 0.001). Medicare (OR 1.54, 95% CI 1.33–1.78, p < 0.001) and Medicaid (OR 1.31, 95% CI 1.08–1.60, p = 0.007) patients undergoing bariatric surgery had an increased risk of complications compared to privately insured patients.

Conclusions

Publicly insured patients are significantly less likely to undergo bariatric surgery. As a group, these patients experience higher rates of obesity and related complications and thus are most in need of bariatric surgery.
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Metadata
Title
The Inequity of Bariatric Surgery: Publicly Insured Patients Undergo Lower Rates of Bariatric Surgery with Worse Outcomes
Authors
Dietric L. Hennings
Maria Baimas-George
Zaid Al-Quarayshi
Rachel Moore
Emad Kandil
Christopher G. DuCoin
Publication date
01-01-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2784-5

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