title: Pay Status as a Predictor of Outcome in Surgical Treatment of Obesity.
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.
authors.affiliation: National Bariatric Surgery Registry, The University of Iowa College of Medicine, Department of Surgery, Iowa City, IOWA, 52232, USA.
authors.initials: KE
authors.lastname: Renquist
authors.initials: EE
authors.lastname: Mason
authors.initials: S
authors.lastname: Tang
authors.initials: JJ
authors.lastname: Cullen
authors.initials: C
authors.lastname: Doherty
authors.initials: JW
authors.lastname: Maher