Janette P Gomez1, Michael A Davis1, Gus J Slotman2. 1. Department of Surgery, Inspira Health Network, 1505 West Sherman Avenue, Suite B, Vineland, NJ 08360, USA. 2. Department of Surgery, Inspira Health Network, 1505 West Sherman Avenue, Suite B, Vineland, NJ 08360, USA. Electronic address: SlotmanG@ihn.org.
Abstract
BACKGROUND: Differences in Medicaid vs Medicare vs Private vs Self-Pay duodenal switch (DS) results are unknown. This study identified DS outcomes variations by health insurance. METHODS: Data from 1,681 DS patients were analyzed retrospectively: Medicaid (n = 138), Medicare (n = 313), Private insurance (n = 1,171), and Self-Pay (n = 59). General linear models included baseline and postoperative data and were modified for dichotomous variables. RESULTS: Hypertension, obstructive sleep apnea, abdominal hernia, diabetes, and 9 other hepatobiliary, and somatic conditions were lowest in Private (P < .05). Self-Pay cholelithiasis, gastroesophageal reflux disease, back and/or musculoskeletal pain, and 3 others were lowest; asthma, angina, congestive heart failure, alcohol use, liver disease, and 3 others were highest (P < .05). Medicare had highest abdominal hernia and musculoskeletal pain, pseudotumor cerebri; lowest asthma, and polycystic ovarian syndrome (P < .05). Medicaid hypertension, sleep apnea, cholelithiasis, gastroesophageal reflux disease, diabetes, back pain, and 5 others were highest (P < .05); dyslipidemia and alcohol use were lowest. CONCLUSIONS: Outcomes after DS vary by health insurance. These findings may facilitate management of DS patients.
BACKGROUND: Differences in Medicaid vs Medicare vs Private vs Self-Pay duodenal switch (DS) results are unknown. This study identified DS outcomes variations by health insurance. METHODS: Data from 1,681 DS patients were analyzed retrospectively: Medicaid (n = 138), Medicare (n = 313), Private insurance (n = 1,171), and Self-Pay (n = 59). General linear models included baseline and postoperative data and were modified for dichotomous variables. RESULTS:Hypertension, obstructive sleep apnea, abdominal hernia, diabetes, and 9 other hepatobiliary, and somatic conditions were lowest in Private (P < .05). Self-Pay cholelithiasis, gastroesophageal reflux disease, back and/or musculoskeletal pain, and 3 others were lowest; asthma, angina, congestive heart failure, alcohol use, liver disease, and 3 others were highest (P < .05). Medicare had highest abdominal hernia and musculoskeletal pain, pseudotumor cerebri; lowest asthma, and polycystic ovarian syndrome (P < .05). Medicaid hypertension, sleep apnea, cholelithiasis, gastroesophageal reflux disease, diabetes, back pain, and 5 others were highest (P < .05); dyslipidemia and alcohol use were lowest. CONCLUSIONS: Outcomes after DS vary by health insurance. These findings may facilitate management of DS patients.
Authors: Erin Takemoto; Bruce M Wolfe; Corey L Nagel; Walter Pories; David R Flum; Alfons Pomp; James Mitchell; Janne Boone-Heinonen Journal: Int J Obes (Lond) Date: 2018-06-11 Impact factor: 5.095