PAY STATUS AS A PREDICTOR OF OUTCOME IN SURGICAL-TREATMENT OF OBESITY

Background: Higher complication rates and lower success in surgery for severe obesity have been reported for patients with government pay st atus. We examined the effect of pay status upon outcome in surgical tr eatment of obesity. Methods: This was an observational study from an a ggregate data set of individual patient information, Government pay st atus (G) was defined as full or partial medical care payment through M edicare, Medicaid, or Veterans Administration. Payment entirely by pri vate insurance was defined as private (P). Operations were classified as either simple (S, gastric restriction) or complex (C, gastric restr iction with small bowel bypass). Two measures of outcome, perioperativ e complication rate and weight loss success (less than or equal to 50% excess weight), were examined to determine pay status effect. Results : More G than P patients were treated with simple procedures (79% vs 5 1%, p <0.05). Perioperative complication rates were more common for G than P patients (14.4% vs 9.1%, p <0.05). One-year weight loss success was higher for P than G, regardless of operation type. Conclusion: Pa y status should be included in characterization of patient groups and in the analysis of results when effectiveness of surgical treatment fo r severe obesity is reported.