The effect of Medicaid status on weight loss, hospital length of stay, and 30-day readmission after laparoscopic Roux-en-Y gastric bypass surgery.

Published

Journal Article

BACKGROUND: Patients with Medicaid are much less likely to undergo bariatric surgery compared to those with commercial insurance. The aims of this study were to compare outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB) for patients covered by Medicaid, other (non-Medicaid) government insurance, and commercial insurance. METHODS: This was a retrospective cohort study of all eligible patients who underwent LRYGB between July 2004 and October 2011 at a single university hospital (n = 450). Multivariable regression analysis was used to compare percent weight loss (PWL), absolute weight loss (AWL), hospital length of stay (LOS) ≥3 days, and 30-day readmission rates. Analyses were adjusted for appropriate covariates. RESULTS: There was a nonsignificant increase in PWL in Medicaid patients at 2 months (p = 0.08), 6 months (p = 0.09), and 12 months (p = 0.17) compared to commercial insurance patients. Similarly, there was a nonsignificant increase in AWL in Medicaid patients at 2 months (p = 0.054), 6 months (p = 0.08), and 12 months (p = 0.14) compared to commercial insurance patients. Medicaid patients had similar PWL and AWL compared to those with other government insurance (p ≥ 0.29 at all time points). Medicaid patients were more likely to have a hospital LOS ≥ 3 days (OR 2.03; 95 % confidence interval (CI) 1.09-3.77) and a hospital readmission within 30 days of discharge (odds ratio (OR) 2.84; 95 % CI 1.15-6.96) compared to commercial insurance patients. CONCLUSIONS: These data should be considered as states expand Medicaid and make decisions regarding treatment of severe obesity. Interventions to decrease hospital LOS and the 30-day readmission rate, particularly in Medicaid patients, should be explored.

Full Text

Duke Authors

Cited Authors

  • Jensen-Otsu, E; Ward, EK; Mitchell, B; Schoen, JA; Rothchild, K; Mitchell, NS; Austin, GL

Published Date

  • 2015-02-01

Published In

Volume / Issue

  • 25 / 2

Start / End Page

  • 295 - 301

PubMed ID

  • 25022673

Pubmed Central ID

  • 25022673

Electronic International Standard Serial Number (EISSN)

  • 1708-0428

Digital Object Identifier (DOI)

  • 10.1007/s11695-014-1367-y

Language

  • eng

Conference Location

  • United States