Insurance payor status and risk of major adverse cardiovascular and cerebrovascular events after metabolic and bariatric surgery.
Surg Obes Relat Dis
; 20(10): 970-975, 2024 Oct.
Article
en En
| MEDLINE
| ID: mdl-38849260
ABSTRACT
BACKGROUND:
Patients with Medicare/Medicaid insurance receive metabolic and bariatric surgery (MBS) at lower rates than privately insured (PI) patients. Although studies on some surgical procedures report that Medicare/Medicaid insurance confers increased postoperative complication rates and a longer length of stay, less is known about these outcomes after MBS. Among often-feared postoperative complications are major adverse cardiovascular and cerebrovascular events (MACEs). Although these events are rare after MBS, they have a significant impact on morbidity and mortality.OBJECTIVES:
This study aimed to examine the effect of insurance payor status on MACEs after MBS.SETTING:
The Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS).METHODS:
HCUP-NIS was queried for cases including sleeve gastrectomy or Roux-en-Y gastric bypass between 2012 and 2019. Bivariate associations between patient-level factors and MACEs were assessed via Rao-Scott χ2 tests. Adjusted and unadjusted risks of insurance payor status for MACEs were evaluated using logistic regression.RESULTS:
Incidence of MACEs was higher in both Medicare (.75% versus .11%; P < .001) and Medicaid (.15% versus .11%; P < .001) groups than in the PI group. After adjustment for high-risk demographics, high-risk co-morbidities, socioeconomic variables, and hospital factors, insurance status of Medicare (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.23, 2.07; P = .0026) or Medicaid (OR 1.55, 95% CI 1.12, 2.16; P = .0026) remained an independent risk factor for MACEs.CONCLUSIONS:
Our findings underscore the significance of Medicaid/Medicare payor status as an independent predictor of postoperative MACEs in MBS. The results of this study can have a significant impact on deepening our understanding of socioeconomic and health system-related issues that can be targeted to improve outcomes in both MBS and other surgical specialties.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Enfermedades Cardiovasculares
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Trastornos Cerebrovasculares
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Medicare
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Medicaid
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Cirugía Bariátrica
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Surg Obes Relat Dis
Asunto de la revista:
METABOLISMO
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Estados Unidos