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Government restrictions on weight loss surgeries limit access for poor, underinsured patients
Date:10/30/2007

ese patients at a time when obesity is rapidly increasing in the population, the study notes.

Researchers led by Dr. Livingston reviewed 51,000 records involving weight-loss surgeries carried out in nearly 750 U.S. hospitals over a three-year span (2001-2003).

Researchers found that statistical sampling methods used in the handful of studies favoring high-volume centers skewed results by amplifying a small number of excess deaths in very low-volume facilities. Databases used in the studies typically had sparse information on individual patients backgrounds. Accounting for the specific health risks of patients, however, often eliminates the advantages seen for high-volume centers, the analysis showed.

Low-volume centers tend to accept higher-risk patients, while high-volume centers gravitate toward more lower-risk patients, the researchers found. In either case, the overall risk was small, as the survival rate at low-income centers was 99.66 percent.

Restricting cases to high-volume centers isnt going to have a profound effect in limiting the number of deaths, but would have a profound effect in limiting accessibility to bariatric surgery, Dr. Livingston said. More likely, the surgeons cumulative experience and access to multidisciplinary teams of doctors available before, during and after surgery result in better outcomes.

Rather than limiting procedures to high-volume centers, bariatric programs should be judged by risk-adjusted outcomes, such as the National Surgical Quality Improvement Program, he said.

Thats important because studies indicate that non-surgical therapies for morbidly obese patients are uniformly unsuccessful for sustained weight loss. In addition, despite increasing numbers of bariatric surgeries performed, they are still dwarfed by the eligible population. The Centers for Disease Control and Prevention estimates that nearly one-third of adult Americans more than 60 million people are obese,
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Contact: Russell Rian
russell.rian@utsouthwestern.edu
214-648-3404
UT Southwestern Medical Center  
Source:Eurekalert

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