Obesity Surgery

, Volume 25, Issue 2, pp 295–301

The Effect of Medicaid Status on Weight Loss, Hospital Length of Stay, and 30-Day Readmission After Laparoscopic Roux-en-Y Gastric Bypass Surgery

  • Elsbeth Jensen-Otsu
  • Emily K. Ward
  • Breana Mitchell
  • Jonathan A. Schoen
  • Kevin Rothchild
  • Nia S. Mitchell
  • Gregory L. Austin
Original Contributions

DOI: 10.1007/s11695-014-1367-y

Cite this article as:
Jensen-Otsu, E., Ward, E.K., Mitchell, B. et al. OBES SURG (2015) 25: 295. doi:10.1007/s11695-014-1367-y

Abstract

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.

Keywords

Severe obesityBariatric surgeryGastric bypassHospital length of stayHospital readmissionWeight lossMedicaid

Abbreviations

BMI

Body mass index

LRYGB

Laparoscopic Roux-en-Y gastric bypass

PWL

Percent weight loss

AWL

Absolute weight loss

SES

Socioeconomic status

LOS

Length of stay

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Elsbeth Jensen-Otsu
    • 1
  • Emily K. Ward
    • 2
  • Breana Mitchell
    • 3
  • Jonathan A. Schoen
    • 3
  • Kevin Rothchild
    • 3
  • Nia S. Mitchell
    • 1
  • Gregory L. Austin
    • 2
  1. 1.Department of MedicineUniversity of Colorado DenverAuroraUSA
  2. 2.Division of Gastroenterology and HepatologyUniversity of Colorado DenverAuroraUSA
  3. 3.Department of SurgeryUniversity of Colorado DenverAuroraUSA