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New studies examine adverse outcomes associated with obesity and more applicable measures of obesity
Date:5/2/2010

uch payment structures fail to account for patient factors that are out of the control of doctors yet influence outcomes, the most common being obesity, which can double a patient's chance of infection.

Studying national insurance claims of 36,483 patients who had undergone one of two common general surgical procedures, Dr. Makary, senior author of the study, found that obese patients undergoing appendectomy were 25 percent more likely to experience complications, and patients undergoing cholecystetomy were 7 percent more likely to have complications. In addition, Makary found that the cost of providing such care was higher for obese patients: the median total inpatient costs for obese patients after a basic gallbladder removal were $2,978 higher and $1,600 higher for appendectomy.

Because obesity rates are higher in minority populations black women have a 50 percent incidence of being overweight compared to 18 percent for white men Dr. Makary expressed concern for the discrimination implications under such payment structures. "What sounds good in theory turns out in reality to punish doctors who take care of more high-risk patients, and actually financially incentivizes discrimination," said Dr. Makary.

Dr. Makary points out that standardized outcomes accounting for patient factors would eliminate the unintended incentives to discriminate. The National Surgical Quality Improvement Program (NSQIP) is a doctor-initiated program that has developed such outcome measures.

Dr. Makary and Dr. Hirose will present these data on Monday, May 3 at 9 a.m. CT in 244-245, Ernest N. Morial Convention Center.

Waist Circumference Predicts Complications in Rectal Cancer Surgery (Abstract # 431)

A patient's waist circumference can serve as a predictor as to whether the patient will experience complications in recovering from rectal cancer surgery, according to researchers at the Michael E. DeBakey VA Medical Center (MEDV
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Contact: Amy Levey
alevey@gymr.com
202-745-5116
Digestive Disease Week
Source:Eurekalert

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