Insurance Status and Outcomes in Laparoscopic Adjustable Gastric Banding (lagb)

Paul R Balash, MD, Nicholas E Bruns, BA, Minh B Luu, MD, Amanda Francescatti, BA, Khristi M Autajay, RD, Jonathan A Myers, MD. Rush University Medical Center


Introduction: In the ongoing battle against the obesity crisis in the United States, surgical treatment has been shown to be superior to medical management. Laparoscopic adjustable gastric banding (LAGB) is a safe, effective and accepted procedure for weight loss. For patients without health insurance or for those who don’t qualify for LAGB under their healthcare policy, the only option is to self-finance the procedure. The aim of this study was to evaluate the effectiveness of LAGB in terms of overall excess weight loss, perioperative outcomes and complications between self-financed and insured patients.

Methods and Procedures: A total of 108 patient underwent LAGB from January 2007 to December 2008 at one surgical center by a single surgeon (JM). There were 61 patients whose procedure was covered by their insurance provider (INS) and 47 patients whose procedure was self-financed (SF). The patient demographics such as age, gender, race, BMI, and co-morbidities were tabulated and compared. Excess weight loss was calculated at 6 months, 12 months, and 18 months. Weight loss was expressed as the percent of excess weight loss (EWL). Statistical analysis was performed using SPSS version 11.5.

Results: Women comprised 81.5% of the patients. Mean age was 40.5 ± 11.0 years and mean BMI was 43.1 ± 5.9 kg/m2. Patients from the INS and SF groups were similar in age, gender, race, and co-morbidities. The mean BMI was higher in the INS group compared to the SF group (44.1 ± 5.17 vs. 41.9 ± 6.56 kg/m2, respectively, P = 0.049). At 6 months, the EWL was 23.4 ± 11.6% for the insured group and 24.0 ± 11.8% for the self-pay group. At 12 months, the EWL was 38.3 ± 19.0% for the insured group and 39.5 ± 18.3% for the self-pay group. At 18 months, the EWL was 44.2 ± 19.1% for the insured group and 48.2 ± 19.6% for the self-pay group. There was no significant difference between the groups at 6 months, 12 months, or 18 months.

Conclusions: Our original hypothesis was that self-financed patients would be more motivated, leading to an increase in excess weight loss compared to insured patients. However, the data has shown that there is no significant difference in excess weight loss between self-financed and insured patients.

Session Number: Poster – Poster Presentations
Program Number: P455
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