Health disparity in access to bariatric surgery.

Autor:	Tsui ST; Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York. Electronic address: to.tsui@stonybrookmedicine.edu., Yang J; Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York., Zhang X; Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York., Tatarian T; Division of Bariatric Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., Docimo S; Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York., Spaniolas K; Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York., Pryor AD; Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.
Jazyk:	angličtina
Zdroj:	Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2021 Feb; Vol. 17 (2), pp. 249-255. Date of Electronic Publication: 2020 Oct 16.
DOI:	10.1016/j.soard.2020.10.015
Abstrakt:	Background: Sociodemographic disparities in terms of access to bariatric surgery are ongoing. Objectives: This study aimed to examine the trends for bariatric interventions based on patient characteristics from 2011 to 2018 in the state of New York. Setting: Administrative statewide database. Methods: This study used the New York Statewide Planning and Research Cooperative System database to identify all patients with obesity who underwent Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB) between 2011 and 2018. The trends were studied for the types of bariatric procedures performed across different patient characteristics, including median household income as determined based on ZIP code. A multivariable logistic regression analysis was performed to compare the yearly trends. Results: We identified 111,793 patients who underwent bariatric surgery. The number of bariatric procedures increased from 9304 in 2011 to 16,946 in 2018. RYGB was the most performed bariatric operation in 2011, but was replaced by SG from 2013 to 2018. Patients living in the highest decile median household income ZIP code areas had the highest increase in SG (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.46-1.55; P < .0001) and the largest decrease in LAGB (OR, .53; 95% CI, .51-.56; P = .0007). Conclusions: The use of bariatric surgery increased significantly from 2011 to 2018. However, the disproportionately and substantially increased use of SG and the decreased use of LAGB in patients living in wealthier areas suggest that disparity in the use of bariatric interventions still exists. Public health efforts should be made to equalize access to bariatric surgery. (Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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