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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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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.

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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

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Conflict of Interest

No conflicts of interest exist for any of the authors of this manuscript. No funding was obtained for this study.

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Authors and Affiliations

  1. Department of Medicine, University of Colorado Denver, 12631 E. 17th Ave., Room 8603, Aurora, CO, USA

    Elsbeth Jensen-Otsu & Nia S. Mitchell

  2. Division of Gastroenterology and Hepatology, University of Colorado Denver, 12631 E. 17th Ave., Room 7609, Aurora, CO, USA

    Emily K. Ward & Gregory L. Austin

  3. Department of Surgery, University of Colorado Denver, 12631 E. 17th Ave., Room 6001, Aurora, CO, USA

    Breana Mitchell, Jonathan A. Schoen & Kevin Rothchild

Authors
  1. Elsbeth Jensen-Otsu
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  2. Emily K. Ward
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  3. Breana Mitchell
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  4. Jonathan A. Schoen
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  5. Kevin Rothchild
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  6. Nia S. Mitchell
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  7. Gregory L. Austin
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Correspondence to Gregory L. Austin.

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Jensen-Otsu, E., Ward, E.K., Mitchell, B. et al. The Effect of Medicaid Status on Weight Loss, Hospital Length of Stay, and 30-Day Readmission After Laparoscopic Roux-en-Y Gastric Bypass Surgery. OBES SURG 25, 295–301 (2015). https://doi.org/10.1007/s11695-014-1367-y

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  • DOI: https://doi.org/10.1007/s11695-014-1367-y

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