title: Bariatric outcomes are significantly improved in hospitals with fellowship council-accredited bariatric fellowships.
abstract: BACKGROUND
  With the increasing demand of bariatric surgery, there is a need to train more surgeons, while identifying institutional factors associated with improved outcomes. Little is known regarding the impact of a fellowship training program on institutional outcomes. This study examines the effect of bariatric fellowship program status on perioperative outcomes within New York state.
  
  
  METHODS
  Using the New York statewide planning and research cooperative system, 47,342 adult patients in 91 hospitals were identified who underwent a laparoscopic bariatric surgery over a 6-year period. Hospitals with fellowships were identified from the Fellowship Council. Statistical comparison between patient demographics, payer source, comorbidities, bariatric procedure performed, and perioperative outcomes in hospitals with and without fellowship were performed.
  
  
  RESULTS
  On univariate analysis, fellowship accreditation status was found to be associated with increased rates of cardiac complications and shock and decreased rates of pneumonia. Overall complication rate was not significantly different in fellowship versus non-fellowship institutions. However, when controlled for patient demographic, payer source, comorbidity, and operative procedure, there were significantly improved bariatric outcomes among institutions with fellowship programs.
  
  
  CONCLUSIONS
  The presence of a fellowship program correlates with improved hospital outcomes, mitigating potential concerns about possible negative effects of trainees on hospitals and patients.
authors: Department of Surgery, Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Stony Brook Medicine, 101 Nicolls Road, HSC 18-040, Stony Brook, NY, 11794, USA.
authors: Pamela S
authors: PS
authors: Kim
authors: Dana A
authors: DA
authors: Telem
authors: Maria S
authors: MS
authors: Altieri
authors: Mark
authors: M
authors: Talamini
authors: Jie
authors: J
authors: Yang
authors: Qiao
authors: Q
authors: Zhang
authors: Aurora D
authors: AD
authors: Pryor
mesh_terms: D000068:Accreditation; D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000193:education*; D005257:Fellowships and Scholarships; D005260:Female; D006761:Hospitals; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000193:education*; D008297:Male; D008875:Middle Aged; D009518:New York; D009765:Obesity / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult