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Two-Year Outcomes for Medicaid Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass: a Case-Control Study

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Abstract

Background

Millions of patients will be added to Medicaid programs throughout the country due to expansion driven by the Affordable Care Act. Since 90 % of state Medicaid programs cover bariatric surgery, the outcomes of Medicaid patients will be important to study. We performed a retrospective analysis to compare outcomes between Medicaid and non-Medicaid bariatric surgery patients over a two-year period.

Methods

All patients who underwent a laparoscopic Roux-en-Y gastric bypass at The Ohio State University Medical Center from January 2008–April 2011 were identified. Of these 609 patients, 30 Medicaid patients were identified and compared to 90 randomly selected non-Medicaid patients (1:3 case-control). Preoperative data and postoperative outcome data (weight loss, comorbidity resolution, complications, and mortality) were obtained from electronic medical records. Descriptive statistical analyses were performed to compare categorical and continuous variables.

Results

Medicaid patients had a significantly higher average BMI (58.4 vs. 49.5; p < 0.001) and higher rates of comorbidities. Over a 90-day postoperative period, Medicaid patients experienced a higher wound complication rate (20.0 vs. 5.6 %; p = 0.03) and visited the ER more frequently (33.3 vs. 10.0 %; p = 0.007) but had similar rates of medical complications compared to non-Medicaid patients. The Medicaid cohort lost 52.1 % of its excess body weight vs. 64.6 % for the non-Medicaid cohort (p = 0.02) over a two-year period. There were no significant differences in comorbidity resolution, anastomotic complications, or mortality after 2 years of follow-up.

Conclusion

Despite being a higher risk cohort, Medicaid patients undergoing laparoscopic Roux-en-Y gastric bypass had similar long-term outcomes compared to non-Medicaid patients.

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Conflict of Interest

Drs. Funk, Mikami and Needleman, and Mr. Suzo have nothing to disclose.

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Authors and Affiliations

  1. Department of Surgery, Wisconsin Surgical Outcomes Research Group (WiSOR), University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, H4/728 Clinical Science Center, Madison, WI, 53792-7375, USA

    Luke M Funk

  2. Department of Surgery, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, 558 Doan Hall, 410 W. 10th Avenue, Columbus, OH, 43210, USA

    Andrew Suzo, Dean J Mikami & Bradley J Needleman

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  1. Luke M Funk
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  2. Andrew Suzo
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Correspondence to Luke M Funk.

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Funk, L.M., Suzo, A., Mikami, D.J. et al. Two-Year Outcomes for Medicaid Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass: a Case-Control Study. OBES SURG 24, 1679–1685 (2014). https://doi.org/10.1007/s11695-014-1236-8

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  • DOI: https://doi.org/10.1007/s11695-014-1236-8

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