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The Role of Insurance Type in Bariatric Surgery Outcomes

Mauricio Sarmiento Cobos, MD, Giulio Giambartolomei, MD, David Gutierrez Blanco, MD, Emanuele Lo Menzo, MD, PhD, FACS, Rama Ganga, MD, Samuel Szomstein, MD, FACS, Raul J Rosenthal, MD, FACS. Cleveland Clinic Florida

BACKGROUND: Bariatric surgery has shown to be the most effective treatment, with documented improvement in obesity-related comorbidities. The type of health insurance coverage plays an important role in the access to bariatric surgery, but might also affect postoperative outcomes.

The objective of this study is to determine whether there is a difference in outcomes based on the type of insurance 12 months after bariatric surgery.

METHODS: We retrospectively reviewed all the patients that underwent bariatric surgery at our institution from 2010 to 2016. We divided the patients into two groups, based on the type of insurance, Private (group one), and Public (group two). We compared demographics and 12 months outcomes between the groups, using t-test for continuous variables and chi-square for categorical variables. We also compared 12 months estimated BMI loss between 8 different private insurances using ANOVA.

RESULTS: Out of 1399 bariatric patients, 507 (36.24%) matched our search criteria. We identified 340 (67%) patients in group one and 167 (32%) in group two. In group one 67.94% (N=231) were females versus 61.07% (N=102) in group two (P=0.12). The average age in group one was 46.54+10.81 years and 59.33+12.16 years in group two  (P<0.001). The percentage of estimated BMI loss (EBMIL%) at 3 months in group one was 41.73+10.99 (N=340) versus 42.16+10.35 (N=167) in group two (p=0.674). The EBMIL% at 12 months was 69.80+ 23.19 (N=340) in group one vs. 62.29+ 28.63 (N=167) in group two (p=0.002).Diagnosis of Diabetes was found in 51.76% (n=176) of the patients in group one versus 73.05 (n=122) in group two (p<0.001). Diagnosis of Hypertension was found in 44.70%  (n=152) of the patients in group one versus 59.88% (n=100) in group two (0.001).

Comparison between 8 different private insurance subgroups did not show any statistical significance in weight loss patterns.

CONCLUSION: Bariatric patients were more likely to be privately insured. Our study demonstrates that privately insured patients have less comorbidity at baseline, and they are prone to lose more weight compared to publicly insured patients after a12 months follow-up. Further studies may be needed to better assess these findings.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87068

Program Number: P661

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

51

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