Pay Status as a Predictor of Outcome in Surgical Treatment of Obesity |
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| Authors: | Kathleen E Renquist BS Edward E Mason MD PhD Shenghui Tang MS Joseph J Cullen MD Cornelius Doherty MD James W Maher MD |
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| Affiliation: | (1) National Bariatric Surgery Registry, The University of Iowa College of Medicine, Department of Surgery, IA, USA;(2) National Bariatric Surgery Registry, The University of Iowa College of Medicine, Department of Surgery, IA, USA;(3) Department of Preventive Medicine, IA, USA;(4) National Bariatric Surgery Registry, The University of Iowa College of Medicine, Department of Surgery, IA, USA;(5) National Bariatric Surgery Registry, The University of Iowa College of Medicine, Department of Surgery, IA, USA;(6) National Bariatric Surgery Registry, The University of Iowa College of Medicine, Department of Surgery, IA, USA;(7) NBSR Data Contributors: Capella R, Cullen JJ, Doherty C, Drew R, Flanagan L, Fox SR, Galupo PA, Harrison SS, Hess D, Hollingsworth WJ, Jaroch M, LaVanway JM, Lechner GW, Lirio OC, Macgregor A, Maher JW, Mason EE, Newhoff A, Oram-Smith JC, O'Rourke PT, Ozment KJ, Perey B, Pierce EH, Popoola D, Roll W, Rupp WM, Samuels N, Schechner SA, Schreiber H, Terry B, VanNostrand Dm |
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| Abstract: | Background: Higher complication rates and lower success in surgery for severe obesity have been reported for patients with government pay status. We examined the effect of pay status upon outcome in surgical treatment of obesity. Methods: This was an observational study from an aggregate data set of individual patient information. Government pay status (G) was defined as full or partial medical care payment through Medicare, Medicaid, or Veterans Administration. Payment entirely by private insurance was defined as private (P). Operations were classified as either simple (S, gastric restriction) or complex (C, gastric restriction with small bowel bypass). Two measures of outcome, perioperative complication rate and weight loss success (≤50% excess weight), were examined to determine pay status effect. Results: More G than P patients were treated with simple procedures (79% vs 51%, p < 0.05). Perioperative complication rates were more common for G than P patients (14.4% vs 9.1%, p < 0.05). One-year weight loss success was higher for P than G, regardless of operation type. Conclusion: Pay status should be included in characterization of patient groups and in the analysis of results when effectiveness of surgical treatment for severe obesity is reported. |
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| Keywords: | Pay status weight loss success rate follow-up rate perioperative complication rates |
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