title: In the superobese, weight loss and resolution of obesity comorbidities after biliopancreatic bypass and/or duodenal switch vary according to health insurance carrier: Medicaid vs Medicare vs Private insurance vs Self-Pay in 1681 Bariatric Outcomes Longitudinal Database patients.
abstract: BACKGROUND
  Differences in Medicaid vs Medicare vs Private vs Self-Pay duodenal switch (DS) results are unknown. This study identified DS outcomes variations by health insurance.
  
  
  METHODS
  Data from 1,681 DS patients were analyzed retrospectively: Medicaid (n = 138), Medicare (n = 313), Private insurance (n = 1,171), and Self-Pay (n = 59). General linear models included baseline and postoperative data and were modified for dichotomous variables.
  
  
  RESULTS
  Hypertension, obstructive sleep apnea, abdominal hernia, diabetes, and 9 other hepatobiliary, and somatic conditions were lowest in Private (P < .05). Self-Pay cholelithiasis, gastroesophageal reflux disease, back and/or musculoskeletal pain, and 3 others were lowest; asthma, angina, congestive heart failure, alcohol use, liver disease, and 3 others were highest (P < .05). Medicare had highest abdominal hernia and musculoskeletal pain, pseudotumor cerebri; lowest asthma, and polycystic ovarian syndrome (P < .05). Medicaid hypertension, sleep apnea, cholelithiasis, gastroesophageal reflux disease, diabetes, back pain, and 5 others were highest (P < .05); dyslipidemia and alcohol use were lowest.
  
  
  CONCLUSIONS
  Outcomes after DS vary by health insurance. These findings may facilitate management of DS patients.
authors.affiliation: Department of Surgery, Inspira Health Network, 1505 West Sherman Avenue, Suite B, Vineland, NJ 08360, USA.
authors.forename: Janette P
authors.initials: JP
authors.lastname: Gomez
authors.affiliation: Department of Surgery, Inspira Health Network, 1505 West Sherman Avenue, Suite B, Vineland, NJ 08360, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Davis
authors.affiliation: Department of Surgery, Inspira Health Network, 1505 West Sherman Avenue, Suite B, Vineland, NJ 08360, USA. Electronic address: SlotmanG@ihn.org.
authors.forename: Gus J
authors.initials: GJ
authors.lastname: Slotman
mesh_terms: D015904:Biliopancreatic Diversion / Q000379:methods*; D015897:Comorbidity; D004386:Duodenum / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D008484:Medicaid; D006278:Medicare; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D015431:Weight Loss
keywords: Bariatric surgery; Bilio-pancreatic bypass; Duodenal switch; Morbid obesity; Weight loss surgery