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Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy

BACKGROUND: Medicaid patients tend to have poor access to care and suffer from more obesity and obesity-related co-morbidities compared to their privately insured counterparts. The impact of Medicaid status on outcomes after laparoscopic sleeve gastrectomy (LSG) is unknown. The aim of this study was...

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Autores principales: Bellows, Charles F., Gauthier, Jason M., Webber, Larry S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254484/
https://www.ncbi.nlm.nih.gov/pubmed/25489220
http://dx.doi.org/10.4293/JSLS.2014.00280
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author Bellows, Charles F.
Gauthier, Jason M.
Webber, Larry S.
author_facet Bellows, Charles F.
Gauthier, Jason M.
Webber, Larry S.
author_sort Bellows, Charles F.
collection PubMed
description BACKGROUND: Medicaid patients tend to have poor access to care and suffer from more obesity and obesity-related co-morbidities compared to their privately insured counterparts. The impact of Medicaid status on outcomes after laparoscopic sleeve gastrectomy (LSG) is unknown. The aim of this study was to identify factors that influence outcomes following LSG in the adult Medicaid population of Louisiana with particular focus on adherence to bariatric aftercare attendance and access to care. METHODS: A retrospective review of 63 Medicaid patients undergoing LSG was performed. Demographic data, access to care, weight, co-morbidities morbidity, and mortality were analyzed. Changes in weight and obesity-related co-morbidities were analyzed for patients with ≥12 months of follow-up. Regression analyses were used for estimating the relationships among variables. RESULTS: The majority of patients were female and non-Caucasian. The mean age was 38.6 years. Morbidity was 16% and mortality was 0%. The average distance traveled to clinic was 71.9 miles. Within the first year only 10% of the patients attended all post-operative clinic visits. A multiple logistic model showed that the only predictor of clinic attendance was increased age. At a mean follow-up of 17.7 months, the mean percent excess body weight loss was 47.2%. Greater pre-surgical weight was the only variable associated with suboptimal weight loss. Improvement or resolution of all major co-morbidities was seen in 65% of patients. CONCLUSION: Medicaid patients had a poor attendance at bariatric surgery follow up appointments. Since long-term follow-up is critical, we needed to develop strategies that will optimize follow-up in this patient population.
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spelling pubmed-42544842014-12-08 Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy Bellows, Charles F. Gauthier, Jason M. Webber, Larry S. JSLS Scientific Papers BACKGROUND: Medicaid patients tend to have poor access to care and suffer from more obesity and obesity-related co-morbidities compared to their privately insured counterparts. The impact of Medicaid status on outcomes after laparoscopic sleeve gastrectomy (LSG) is unknown. The aim of this study was to identify factors that influence outcomes following LSG in the adult Medicaid population of Louisiana with particular focus on adherence to bariatric aftercare attendance and access to care. METHODS: A retrospective review of 63 Medicaid patients undergoing LSG was performed. Demographic data, access to care, weight, co-morbidities morbidity, and mortality were analyzed. Changes in weight and obesity-related co-morbidities were analyzed for patients with ≥12 months of follow-up. Regression analyses were used for estimating the relationships among variables. RESULTS: The majority of patients were female and non-Caucasian. The mean age was 38.6 years. Morbidity was 16% and mortality was 0%. The average distance traveled to clinic was 71.9 miles. Within the first year only 10% of the patients attended all post-operative clinic visits. A multiple logistic model showed that the only predictor of clinic attendance was increased age. At a mean follow-up of 17.7 months, the mean percent excess body weight loss was 47.2%. Greater pre-surgical weight was the only variable associated with suboptimal weight loss. Improvement or resolution of all major co-morbidities was seen in 65% of patients. CONCLUSION: Medicaid patients had a poor attendance at bariatric surgery follow up appointments. Since long-term follow-up is critical, we needed to develop strategies that will optimize follow-up in this patient population. Society of Laparoendoscopic Surgeons 2014 /pmc/articles/PMC4254484/ /pubmed/25489220 http://dx.doi.org/10.4293/JSLS.2014.00280 Text en © 2014 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Bellows, Charles F.
Gauthier, Jason M.
Webber, Larry S.
Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy
title Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy
title_full Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy
title_fullStr Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy
title_full_unstemmed Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy
title_short Bariatric Aftercare and Outcomes in the Medicaid Population Following Sleeve Gastrectomy
title_sort bariatric aftercare and outcomes in the medicaid population following sleeve gastrectomy
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254484/
https://www.ncbi.nlm.nih.gov/pubmed/25489220
http://dx.doi.org/10.4293/JSLS.2014.00280
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