Sociodemographic trends in bariatric surgery utilization in the USA.
ABSTRACT Although bariatric surgery has become more accessible in recent years, it is unclear whether populations disproportionately affected by obesity are utilizing this treatment. A cross-sectional analysis of the Nationwide Inpatient Sample was performed. The sociodemographic characteristics (race, sex, age, insurance, median income), co-morbidities, and weight loss surgery type were analyzed. Bariatric surgeries increased six-fold from 17,678 in 1998 to 112,882 in 2004 (p < 0.001). Thereafter, bariatric surgeries declined to 93,733 in 2007 (p = 0.24). The proportion of individuals of Other race undergoing bariatric surgery significantly increased, while the proportion of Whites significantly decreased over time. The proportion of individuals in the lowest income quartile (< $25,000) increased, while those in the highest income percentile (> $45,000) decreased. From 1998 to 2007, the sociodemographic characteristics of the bariatric surgery population have changed, although those that are disproportionately affected by morbid obesity continue to be underrepresented.
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ABSTRACT: This study compared pre- and post-surgical data and outcomes among gastric bypass patients based on the type of insurance (Medicaid, Medicare, or private).Obesity Surgery 11/2014; DOI:10.1007/s11695-014-1478-5 · 3.74 Impact Factor
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ABSTRACT: Ethnic minority adults have disproportionately higher rates of obesity than Caucasians but are less likely to undergo bariatric surgery. Recent data suggest that minorities might be less likely to seek surgery. Whether minorities who seek surgery are also less likely to proceed with surgery is unclear. We interviewed 651 patients who sought bariatric surgery at two academic medical centers to examine whether ethnic minorities are less likely to proceed with surgery than Caucasians and whether minorities who do proceed with surgery have higher illness burden than their counterparts. We collected patient demographics and abstracted clinical data from the medical records. We then conducted multivariable analyses to examine the association between race and the likelihood of proceeding with bariatric surgery within 1 year of initial interview and to compare the illness burden by race and ethnicity among those who underwent surgery. Of our study sample, 66 % were Caucasian, 18 % were African-American, and 12 % were Hispanics. After adjustment for socioeconomic factors, there were no racial differences in who proceeded with bariatric surgery. Among those who proceeded with surgery, illness burden was comparable between minorities and Caucasian patients with the exception that African-Americans were underrepresented among those with reflux disease (0.4, 95 % CI 0.2-0.7) and depression (0.4, 0.2-0.7), and overrepresented among those with anemia (4.8, 2.4-9.6) than Caucasian patients. Race and ethnicity were not independently associated with likelihood of proceeding with bariatric surgery. Minorities who proceeded with surgery did not clearly have higher illness burden than Caucasian patients.Surgical Endoscopy 12/2014; DOI:10.1007/s00464-014-4014-8 · 3.31 Impact Factor
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ABSTRACT: Standard obstructive sleep apnea (OSA) therapies are poorly tolerated. Bariatric surgery is a potential alternative but the level of interest in this intervention among OSA patients is unknown. Determine the proportion of OSA patients who would be interested in bariatric surgery. Sleep clinics, United States. Consecutive adult patients with untreated severe OSA and a body mass index of 35-45 kg/m(2) were approached. Patients at low perioperative risk and no urgent indication for OSA treatment were invited to a separate informational visit about bariatric surgery as primary treatment for OSA. Of 767 eligible patients, 230 (30.0%) were not at low perioperative risk, 49 (6.4%) had drowsy driving, and 16 (2.1%) had no insurance coverage for bariatric surgery. Of the remaining 482 patients, over one third (35.5%) were interested in bariatric surgery. Surgical interest was 47.2% in women versus 27.6% in men (P<0.01) and 67.3% in diabetics versus 31.0% in nondiabetics (P<0.01). In multivariable adjusted models, female gender (odds ratio 1.89, 95% CI [1.10-3.25]) and diabetes (odds ratio 3.97, 95% CI [1.97-8.01]) remained highly predictive of bariatric surgery interest. Nearly two thirds of obese patients with severe OSA are good candidates for bariatric surgery. Among candidates, over one third are interested in this treatment. Interest rates are highest among women and diabetics, indicating that metabolic improvements continue to be a major driver of surgery even in patients with severe OSA. Given patient interest, the role of bariatric surgery should be routinely discussed with obese OSA patients. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.Surgery for Obesity and Related Diseases 01/2015; DOI:10.1016/j.soard.2015.01.006 · 4.94 Impact Factor