Health disparity in access to bariatric surgery.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 05 08 2020
revised: 20 09 2020
accepted: 09 10 2020
pubmed: 30 11 2020
medline: 25 5 2021
entrez: 29 11 2020
Statut: ppublish

Résumé

Sociodemographic disparities in terms of access to bariatric surgery are ongoing. This study aimed to examine the trends for bariatric interventions based on patient characteristics from 2011 to 2018 in the state of New York. Administrative statewide database. This study used the New York Statewide Planning and Research Cooperative System database to identify all patients with obesity who underwent Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB) between 2011 and 2018. The trends were studied for the types of bariatric procedures performed across different patient characteristics, including median household income as determined based on ZIP code. A multivariable logistic regression analysis was performed to compare the yearly trends. We identified 111,793 patients who underwent bariatric surgery. The number of bariatric procedures increased from 9304 in 2011 to 16,946 in 2018. RYGB was the most performed bariatric operation in 2011, but was replaced by SG from 2013 to 2018. Patients living in the highest decile median household income ZIP code areas had the highest increase in SG (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.46-1.55; P < .0001) and the largest decrease in LAGB (OR, .53; 95% CI, .51-.56; P = .0007). The use of bariatric surgery increased significantly from 2011 to 2018. However, the disproportionately and substantially increased use of SG and the decreased use of LAGB in patients living in wealthier areas suggest that disparity in the use of bariatric interventions still exists. Public health efforts should be made to equalize access to bariatric surgery.

Sections du résumé

BACKGROUND BACKGROUND
Sociodemographic disparities in terms of access to bariatric surgery are ongoing.
OBJECTIVES OBJECTIVE
This study aimed to examine the trends for bariatric interventions based on patient characteristics from 2011 to 2018 in the state of New York.
SETTING METHODS
Administrative statewide database.
METHODS METHODS
This study used the New York Statewide Planning and Research Cooperative System database to identify all patients with obesity who underwent Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB) between 2011 and 2018. The trends were studied for the types of bariatric procedures performed across different patient characteristics, including median household income as determined based on ZIP code. A multivariable logistic regression analysis was performed to compare the yearly trends.
RESULTS RESULTS
We identified 111,793 patients who underwent bariatric surgery. The number of bariatric procedures increased from 9304 in 2011 to 16,946 in 2018. RYGB was the most performed bariatric operation in 2011, but was replaced by SG from 2013 to 2018. Patients living in the highest decile median household income ZIP code areas had the highest increase in SG (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.46-1.55; P < .0001) and the largest decrease in LAGB (OR, .53; 95% CI, .51-.56; P = .0007).
CONCLUSIONS CONCLUSIONS
The use of bariatric surgery increased significantly from 2011 to 2018. However, the disproportionately and substantially increased use of SG and the decreased use of LAGB in patients living in wealthier areas suggest that disparity in the use of bariatric interventions still exists. Public health efforts should be made to equalize access to bariatric surgery.

Identifiants

pubmed: 33249086
pii: S1550-7289(20)30605-5
doi: 10.1016/j.soard.2020.10.015
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

249-255

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Stella T Tsui (ST)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York. Electronic address: to.tsui@stonybrookmedicine.edu.

Jie Yang (J)

Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York.

Xiaoyue Zhang (X)

Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York.

Talar Tatarian (T)

Division of Bariatric Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

Salvatore Docimo (S)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

Konstantinos Spaniolas (K)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

Aurora D Pryor (AD)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

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Classifications MeSH