Postoperative outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program
| Autor: | John D. Scott, Megan Miller, Joseph A. Ewing, Allyson L. Hale, Andrew M Schneider, Deborah A. Hutcheon |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Sleeve gastrectomy Diet Reducing medicine.medical_treatment Gastric bypass Gastric Bypass Bariatric Surgery 030209 endocrinology & metabolism Insurance Coverage Teaching hospital 03 medical and health sciences 0302 clinical medicine Gastrectomy Weight loss Preoperative Care Weight management Humans Medicine Prospective Studies Patient participation Retrospective Studies Insurance Health business.industry Middle Aged Surgery Weight Reduction Programs Treatment Outcome Patient Compliance Referral center Female 030211 gastroenterology & hepatology medicine.symptom business Surgical patients |
| Zdroj: | Surgery for Obesity and Related Diseases. 14:623-630 |
| ISSN: | 1550-7289 |
| Popis: | Background Many insurance companies require patient participation in a medically supervised weight management program (WMP) before offering approval for bariatric surgery. Clinical data surrounding benefits of participation are limited. Objective To evaluate the relationship between preoperative insurance-mandated WMP participation and postoperative outcomes in bariatric surgery patients. Setting Regional referral center and teaching hospital. Methods A retrospective review of patients who underwent vertical sleeve gastrectomy or Roux-en-Y gastric bypass between January 2014 and January 2016 was performed. Patients (N = 354) were divided into 2 cohorts and analyzed according to presence (n = 266) or absence (n = 88) of an insurance-mandated WMP requirement. Primary endpoints included rate of follow-up and percent of excess weight loss (%EWL) at postoperative months 1, 3, 6, and 12. All patients, regardless of the insurance-mandated WMP requirement, followed a program-directed preoperative diet. Results The majority of patients with an insurance-mandated WMP requirement had private insurance (63.9%). Both patient groups experienced a similar proportion of readmissions and reoperations, rate of follow-up, and %EWL at 1, 3, 6, and 12 months ( P = NS). Median operative duration and hospital length of stay were also similar between groups. Linear regression analysis revealed no significant improvement in %EWL at 12 months in the yes-WMP group. Conclusion These data show that patients who participate in an insurance-mandated WMP in addition to completing a program-directed preoperative diet experience no significant benefit to rate of readmission, reoperation, follow-up, or %EWL up to 12 months postoperation. Our findings suggest that undergoing bariatric surgery without completing an insurance-mandated WMP is safe and effective. |
| Databáze: | OpenAIRE |
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