Insurance payor status and risk of major adverse cardiovascular and cerebrovascular events after metabolic and bariatric surgery
Document Type
Article
Publication Date
5-8-2024
Publication Title
Surgery for Obesity and Related Diseases
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.
PubMed ID
38849260
Recommended Citation
Corpodean, Florina; Kachmar, Michael; Adepoju, Linda; Danos, Denise; Cook, Michael; Schauer, Philip R.; and Albaugh, Vance L., "Insurance payor status and risk of major adverse cardiovascular and cerebrovascular events after metabolic and bariatric surgery" (2024). School of Medicine Faculty Publications. 2623.
https://digitalscholar.lsuhsc.edu/som_facpubs/2623
10.1016/j.soard.2024.04.017