The Effect of Medicaid Status on Weight Loss, Hospital Length of Stay, and 30-Day Readmission After Laparoscopic Roux-en-Y Gastric Bypass Surgery
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- Jensen-Otsu, E., Ward, E.K., Mitchell, B. et al. OBES SURG (2015) 25: 295. doi:10.1007/s11695-014-1367-y
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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.
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.
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.
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.
KeywordsSevere obesityBariatric surgeryGastric bypassHospital length of stayHospital readmissionWeight lossMedicaid
Body mass index
Laparoscopic Roux-en-Y gastric bypass
Percent weight loss
Absolute weight loss
Length of stay