The impact of the affordable care act on access to bariatric surgery in Maryland.

Autor: Akinyemi OA; Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA. Electronic address: oluwasegun.akinyemi@howard.edu., Weldeslase TA; Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA., Fasokun M; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA., Griffiths Y; Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA., Andine T; Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA., Odusanya E; Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA., Williams M; Department of Surgery, Howard University College of Medicine, Washington, DC, USA., Hughes K; Department of Surgery, Howard University College of Medicine, Washington, DC, USA., Cornwell E 3rd; Department of Surgery, Howard University College of Medicine, Washington, DC, USA., Fullum T; Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Sep; Vol. 235, pp. 115609. Date of Electronic Publication: 2023 Dec 26.
DOI: 10.1016/j.amjsurg.2023.12.021
Abstrakt: Introduction: This study aims to investigate the influence of the Affordable Care Act (ACA) on the utilization of Roux-en-Y gastric bypass (RYGB) procedures in Maryland.
Methods: Using the Maryland State Inpatient Database, this retrospective study compared all patients undergoing RYGB during the pre-ACA (2007-2009) and post-ACA (2018-2020) periods, including patient demographic factors, pre-existing conditions, and socioeconomic factors.
Results: A total of 16,494 RYGB procedures were performed during the study period, of which 12,089 (73.3 ​%) were post-ACA. This was a 179.2 ​% increase in patients undergoing RYGB post-ACA; nearly triple that of the pre-ACA period. There was a significant decrease in uninsured patients (5.6 ​%-1.5 ​%, p ​< ​0.01) an increase in Black patients (32.1 ​%-46.8 ​%, p ​< ​0.01) and Medicaid beneficiaries (6.0 ​% pre-ACA to 17.8 ​% post-ACA, p ​< ​0.01). There were significant reductions in adverse outcomes (long hospital stays, hemorrhage, GIT leaks, and mortality) across all insurance types (all p ​< ​0.01).
Conclusion: The ACA increased access to RYGB procedures, especially in Black and Medicaid recipients in Maryland, enhancing healthcare across all insurance types.
Competing Interests: Declaration of competing interest We have no conflicts of interest to disclose. During the preparation of this work the authors did not use AI programs for any reason beyond checking grammar, spelling, and references.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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