title: One-year Surgical Outcomes and Costs for Medicaid Versus Non-Medicaid Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass: A Single-Center Study.
abstract: OBJECTIVE
  To compare 1-year outcomes and costs between severely obese Medicaid and non-Medicaid patients who underwent laparoscopic Roux-en-Y gastric bypass surgery.
  
  
  METHODS
  This is a single-institution retrospective review comparing 33 Medicaid patients to 99 randomly selected non-Medicaid patients (1:3 case-control). Ninety-day and 1-year outcomes were extracted from the electronic health record. Costs were obtained from the UW information technology division. Bivariate analyses were used to compare study variables.
  
  
  RESULTS
  Emergency department visits (48.2% vs. 27.4%; P=0.06) and readmissions (37.0% vs. 14.7%; P=0.01) were more common for Medicaid patients. Medicaid patients had less excess body weight loss (50.7% vs. 65.6%; P=0.001) but similar comorbidity resolution and complication rates. One-year median costs were similar between Medicaid and non-Medicaid patients ($21,160 vs. $24,215; P=0.92).
  
  
  CONCLUSIONS
  One-year comorbidity resolution, complications, and costs following laparoscopic Roux-en-Y gastric bypass were similar between Medicaid and non-Medicaid patients. Focusing on reducing emergency department presentations and readmissions would be a high-impact area for future quality improvement initiatives.
authors.affiliation: *Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI †Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Ellie Y
authors.initials: EY
authors.lastname: Chen
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Fox
authors.forename: Andrew
authors.initials: A
authors.lastname: Suzo
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Greenberg
authors.forename: Guilherme M
authors.initials: GM
authors.lastname: Campos
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Garren
authors.forename: Luke M
authors.initials: LM
authors.lastname: Funk
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003365:Costs and Cost Analysis; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D015390:Gastric Bypass / Q000191:economics*; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D007902:Length of Stay; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000191:economics / Q000601:surgery*; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology; D012086:Reoperation / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
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