V. Pandit1, A. Azim1, I. Ghaderi1, C. A. Galvani1 1University Of Arizona,Department Of Surgery,Tucson, AZ, USA
Introduction:
Differences in outcomes among patients undergoing general surgical intervention based on racial and socio-economic profile are well established. However; the impact of these differences among bariatric patients still remains unclear. The aim of this study was to evaluate the impact of racial and insurance status on patient outcomes undergoing bariatric surgery (BS).
Methods:
National estimates for BS procedures were abstracted from the National Inpatient Sample (NIS) database (2011). Patients undergoing BS (sleeve gastrectomy, gastric banding) were included. Patients were stratified based on race and insurance status. Outcome measures were: hospital length of stay (LOS), complications, and mortality. Regression analysis was performed after adjusting for age, gender, race, Charlson co-morbidity index (CCI), and type of procedure
Results:
A total of 3,305 patients undergoing BS were analyzed. The mean age was 47.19±13.8 years, 74.8% were females and the mean CCI was 2 [2-3]. 64.1% patients were white and 10.6% were Hispanics. 52.2% patients were private pay. Hispanics patients and non-Hispanic black patients were more likely to develop intra-hospital complications (p=0.031, p=0.043) and have longer hospital stay (p=0.026, p=0.037) compared to non-Hispanic and white patients respectively. On assessing insurance status, patients with Medicare/Medicaid insurance were more likely to have in-hospital complications (p=0.029) compared to private payers. Self-pay patients had lower complication rate ((p=0.041) and length of stay (p=0.033) compared to private payers. On regression analysis, Hispanic (1.28 [1.05-1.45]), non-Hispanic black (1.35 [1.18-2.05]), and Medicare/Medicaid insurance status (1.89 [1.2-3.1]) were independent predictors for development of in-hospital complications. There was no difference in mortality based on racial or socio-economic profile
Conclusion:
Racial and socio-economic disparities are prevalent among patients undergoing bariatric surgery with worse outcomes among Hispanic, Non-Hispanic black, and patients insured with Medicare/Medicaid insurance. Further assessing the causes for these disparities may help improve outcomes among patients undergoing bariatric surgery.