Hamlet Gasoyan1, Jennifer K Ibrahim2, William E Aaronson2, David B Sarwer3. 1. Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania. Electronic address: hamlet.gasoyan@temple.edu. 2. Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania. 3. Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania.
Abstract
BACKGROUND: Bariatric surgery is underutilized in the United States. OBJECTIVE: To examine temporal changes in patient characteristics and insurer type mix among adult bariatric surgery patients in southeastern Pennsylvania and to investigate the associations between payor type, insurance plan type, cost-sharing arrangements (among traditional Medicare beneficiaries), and bariatric surgery utilization. SETTING: Pennsylvania Health Care Cost Containment Council's databases in southeastern Pennsylvania during 2014-2018. METHODS: All adult patients who underwent the most common types of bariatric surgery and a 1:1 matched sample of surgery patients and those who were eligible for surgery but did not undergo surgery were identified. Contingency tables, Pearson χ2 tests, and logistic regression were used for statistical analysis. RESULTS: Over the 5 years, there was an increase in the proportion of Black individuals (37.1% in 2014 versus 43.0% in 2018), Hispanics (5.4% versus 8.0%), and Medicaid beneficiaries (19.2% in 2014 versus 28.5% in 2018) who underwent surgery. The odds of undergoing bariatric surgery based on payor type only between Medicare beneficiaries were statistically different (22% smaller odds) compared with privately insured individuals. There were significantly different odds of undergoing surgery based on insurance plan type within Medicare and private insurance payor categories. Individuals with traditional Medicare plans with no supplementary insurance and those with dual eligibility had smaller odds of undergoing surgery (42% and 32%, respectively) compared with those with private secondary insurance. CONCLUSIONS: Insurance plan design may be as important in determining the utilization of bariatric surgery as the general payor type after controlling for confounding socio-demographic factors.
BACKGROUND: Bariatric surgery is underutilized in the United States. OBJECTIVE: To examine temporal changes in patient characteristics and insurer type mix among adult bariatric surgery patients in southeastern Pennsylvania and to investigate the associations between payor type, insurance plan type, cost-sharing arrangements (among traditional Medicare beneficiaries), and bariatric surgery utilization. SETTING: Pennsylvania Health Care Cost Containment Council's databases in southeastern Pennsylvania during 2014-2018. METHODS: All adult patients who underwent the most common types of bariatric surgery and a 1:1 matched sample of surgery patients and those who were eligible for surgery but did not undergo surgery were identified. Contingency tables, Pearson χ2 tests, and logistic regression were used for statistical analysis. RESULTS: Over the 5 years, there was an increase in the proportion of Black individuals (37.1% in 2014 versus 43.0% in 2018), Hispanics (5.4% versus 8.0%), and Medicaid beneficiaries (19.2% in 2014 versus 28.5% in 2018) who underwent surgery. The odds of undergoing bariatric surgery based on payor type only between Medicare beneficiaries were statistically different (22% smaller odds) compared with privately insured individuals. There were significantly different odds of undergoing surgery based on insurance plan type within Medicare and private insurance payor categories. Individuals with traditional Medicare plans with no supplementary insurance and those with dual eligibility had smaller odds of undergoing surgery (42% and 32%, respectively) compared with those with private secondary insurance. CONCLUSIONS: Insurance plan design may be as important in determining the utilization of bariatric surgery as the general payor type after controlling for confounding socio-demographic factors.
Authors: Leah M Hecht; Bethany Pester; Jordan M Braciszewski; Amy E Graham; Kara Mayer; Kellie Martens; Aaron Hamann; Arthur M Carlin; Lisa R Miller-Matero Journal: Obes Surg Date: 2020-06 Impact factor: 4.129
Authors: Jeffrey I Mechanick; Adrienne Youdim; Daniel B Jones; W Timothy Garvey; Daniel L Hurley; M Molly McMahon; Leslie J Heinberg; Robert Kushner; Ted D Adams; Scott Shikora; John B Dixon; Stacy Brethauer Journal: Surg Obes Relat Dis Date: 2013-01-19 Impact factor: 4.734