Paige L Martinez1, Larissa A McGarrity2, Natalie A Turner1, Eric T Volckmann1, Rebecca M Kohler1, Ellen H Morrow1, Anna R Ibele3. 1. Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. 2. Division of Physical Medicine & Rehabilitation, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. 3. Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. Anna.ibele@hsc.utah.edu.
Abstract
PURPOSE: In spite of widespread recommendations for lifelong patient follow-up with a bariatric provider after bariatric surgery, attrition to follow-up is common. Over the past two decades, many programs have sought to expand access to care for patients lacking insurance coverage for bariatric surgery by offering "self-pay" packages; however, the impact of this financing on long-term follow-up is unclear. We sought to determine whether payer status impacts loss to follow-up within 1 year after bariatric surgery. MATERIALS AND METHODS: Records of 554 consecutive patients undergoing bariatric surgery who were eligible for 1-year post-surgical follow-up between 2014 and 2019 were retrospectively reviewed. Multiple logistic regression examined the relationship between demographics, psychological variables, payer status, and loss to follow-up. RESULTS: Self-pay status more than tripled the odds of loss to follow-up (OR = 3.44, p < 0.01) at 1 year following surgery. Males had more than double the odds of attrition (OR = 2.43, p < 0.01), and members of racial and ethnic minority groups (OR = 2.51, p < 0.05) were more likely to experience loss. CONCLUSIONS: Self-pay patients, males and members of racial and ethnic minority groups, may face additional barriers to long-term access to postoperative bariatric care. Further investigation is greatly needed to develop strategies to overcome barriers to and disparities in long-term post-surgical care for more frequently lost groups.
PURPOSE: In spite of widespread recommendations for lifelong patient follow-up with a bariatric provider after bariatric surgery, attrition to follow-up is common. Over the past two decades, many programs have sought to expand access to care for patients lacking insurance coverage for bariatric surgery by offering "self-pay" packages; however, the impact of this financing on long-term follow-up is unclear. We sought to determine whether payer status impacts loss to follow-up within 1 year after bariatric surgery. MATERIALS AND METHODS: Records of 554 consecutive patients undergoing bariatric surgery who were eligible for 1-year post-surgical follow-up between 2014 and 2019 were retrospectively reviewed. Multiple logistic regression examined the relationship between demographics, psychological variables, payer status, and loss to follow-up. RESULTS: Self-pay status more than tripled the odds of loss to follow-up (OR = 3.44, p < 0.01) at 1 year following surgery. Males had more than double the odds of attrition (OR = 2.43, p < 0.01), and members of racial and ethnic minority groups (OR = 2.51, p < 0.05) were more likely to experience loss. CONCLUSIONS: Self-pay patients, males and members of racial and ethnic minority groups, may face additional barriers to long-term access to postoperative bariatric care. Further investigation is greatly needed to develop strategies to overcome barriers to and disparities in long-term post-surgical care for more frequently lost groups.
Entities:
Keywords:
Attrition; Bariatric surgery; Disparities; Ethnicity; Gender; Insurance; Loss to follow-up; Outcomes; Payer; Self-pay
Authors: Pierre-Yves Cremieux; Henry Buchwald; Scott A Shikora; Arindam Ghosh; Haixia Elaine Yang; Marric Buessing Journal: Am J Manag Care Date: 2008-09 Impact factor: 2.229
Authors: Matthew D Pichert; Maureen E Canavan; Richard C Maduka; Andrew X Li; Theresa Ermer; Peter L Zhan; Michael Kaminski; Brooks V Udelsman; Justin D Blasberg; Henry S Park; Sarah B Goldberg; Daniel J Boffa Journal: JAMA Netw Open Date: 2022-08-01