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Centers of Excellence in Bariatric Surgery: design, implementation, and one-year outcomes.

Publication ,  Journal Article
Bradley, DW; Sharma, BK
Published in: Surg Obes Relat Dis
2006

BACKGROUND: Bariatric surgery procedures increased from <20,000 annually in the early 1990s to >100,000 in 2003. The complications related to surgery have increased disproportionately, causing some payers to discontinue coverage for bariatric procedures and reducing patient access to an effective treatment modality. This report describes an alternative approach-the creation of a network of Centers of Excellence (COE) in Bariatric Surgery. METHODS: Blue Cross and Blue Shield of North Carolina developed a COE program by working collaboratively with the bariatric surgery community. Through systematic review, the collaborative identified bariatric surgical programs that appropriately select patients, comprehensively evaluate and prepare patients for surgery, produce superior outcomes, and provide long-term follow-up for patients. RESULTS: Seven practices were selected as Blue Cross and Blue Shield of North Carolina Bariatric Surgery COE. The short-term results comparing the 12 months before COE implementation and the 12 months after implementation included a 14% decline in the number of bariatric procedures performed (693 versus 596), a 23% decrease in the number of surgeons billing for bariatric procedures (53 versus 41), a 30-day readmission rate of 4.7% for COE providers and 8.3% for non-COE providers, and an average inpatient length of stay of 2.5 days for COE providers and 3.0 days for non-COE providers. The proportion of procedures performed by the COE providers increased from 55% to 61%. CONCLUSION: The preliminary results are encouraging, with COE providers demonstrating reduced 30-day readmission rates and, surprisingly, overall reductions in the rate and number of procedures performed and the number of physicians performing them.

Duke Scholars

Published In

Surg Obes Relat Dis

DOI

ISSN

1550-7289

Publication Date

2006

Volume

2

Issue

5

Start / End Page

513 / 517

Location

United States

Related Subject Headings

  • Surgery
  • Program Development
  • Models, Organizational
  • Length of Stay
  • Humans
  • Health Facilities
  • Bariatrics
  • Bariatric Surgery
  • 4206 Public health
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bradley, D. W., & Sharma, B. K. (2006). Centers of Excellence in Bariatric Surgery: design, implementation, and one-year outcomes. Surg Obes Relat Dis, 2(5), 513–517. https://doi.org/10.1016/j.soard.2006.06.005
Bradley, Don W., and Bal K. Sharma. “Centers of Excellence in Bariatric Surgery: design, implementation, and one-year outcomes.Surg Obes Relat Dis 2, no. 5 (2006): 513–17. https://doi.org/10.1016/j.soard.2006.06.005.
Bradley DW, Sharma BK. Centers of Excellence in Bariatric Surgery: design, implementation, and one-year outcomes. Surg Obes Relat Dis. 2006;2(5):513–7.
Bradley, Don W., and Bal K. Sharma. “Centers of Excellence in Bariatric Surgery: design, implementation, and one-year outcomes.Surg Obes Relat Dis, vol. 2, no. 5, 2006, pp. 513–17. Pubmed, doi:10.1016/j.soard.2006.06.005.
Bradley DW, Sharma BK. Centers of Excellence in Bariatric Surgery: design, implementation, and one-year outcomes. Surg Obes Relat Dis. 2006;2(5):513–517.
Journal cover image

Published In

Surg Obes Relat Dis

DOI

ISSN

1550-7289

Publication Date

2006

Volume

2

Issue

5

Start / End Page

513 / 517

Location

United States

Related Subject Headings

  • Surgery
  • Program Development
  • Models, Organizational
  • Length of Stay
  • Humans
  • Health Facilities
  • Bariatrics
  • Bariatric Surgery
  • 4206 Public health
  • 3202 Clinical sciences