As a group, Medicare patients had more preexisting health problems (comorbidities), such as diabetes, heart failure, and chronic lung disease, than non-Medicare patients did. Overall, they also fared worse after bariatric operations than non-Medicare patients did; findings that other studies also have found, Dr. Nguyen said. Medicare beneficiaries made up about 16 percent of patients who underwent bariatric operations.
In February 2006 the Centers for Medicare and Medicaid Services (CMS) ruled to limit coverage for bariatric operations to only those performed at accredited facilities. However, the agency reversed its decision a year ago, a ruling opposed by the American College of Surgeons (ACS), the ASMBS, and several other surgical and medical organizations.
Accreditation ensures that the facility has the proper infrastructure, equipment, personnel training, and experience with the procedure, as well as other important standards of care, Dr. Nguyen said.
Thus, in order to find whether accreditation status affects outcomes of bariatric procedures among Medicare recipients, the researchers assessed inhospital deaths and other serious complications before (2001 to 2005) and after (2006 to 2010) CMS implemented its National Coverage Determination mandating facility accreditation.
In an effort to eliminate confounding variables that may come into play during these two periods, such as increased implementation of laparoscopic procedures, the investigators also examined the outcomes of accredited versus nonaccredited centers specifically in the latter years, 2006 to 2010. Accreditation of bariatric surgical centers began in 2005, and an estimated 85 percent of bariatric surgical centers held accreditation in 2006, according to Dr. Nguyen.
Serious complications tracked by the researchers included heart attack, stroke, acute kidney failure, acute respiratory failure, complica
|Contact: Sally Garneski|
American College of Surgeons