Obesity Surgery

, Volume 26, Issue 7, pp 1635–1638 | Cite as

An Exploration of System-Level Factors and the Geographic Variation in Bariatric Surgery Utilization

  • Ryan MachtEmail author
  • Amy Rosen
  • Garrick Horn
  • Brian Carmine
  • Donald Hess
Brief Communication


There is wide geographic variation in bariatric surgery rates, although higher regional rates of obesity are not correlated with higher rates of surgery. In this study, four system-level factors were explored as contributors to this geographic variation. Geographic utilization rates of bariatric surgery showed no correlation to the number of bariatric surgeons, number of accredited centers, and the percentage of patients with a recent primary care visit. The total number of surgical discharges was weakly correlated with bariatric surgery rates (r = 0.26, p = <0.001). As surgeon supply, accredited bariatric centers, overall surgical volume, and access to primary care do not appear to heavily influence bariatric surgery rates, future studies are needed to identify additional factors that may explain the underutilization of bariatric surgery.


Bariatric surgery Surgeon supply Geographic variation Obesity treatment disparities System-level factors 


Compliance with Ethical Standards


No grant funding was used to support this study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Human Rights

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this was a retrospective study using deidentified patient data, formal consent was not required.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Ryan Macht
    • 1
    Email author
  • Amy Rosen
    • 1
    • 2
  • Garrick Horn
    • 3
  • Brian Carmine
    • 1
  • Donald Hess
    • 1
  1. 1.Department of SurgeryBoston University School of Medicine and Boston Medical CenterBostonUSA
  2. 2.Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare SystemBostonUSA
  3. 3.Boston University School of MedicineBostonUSA

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