Some 88 hospitals have been rated as "best" performers by the HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study released today. The basis of this rating includes mortality rates, complication rates and patient lengths of stay, which are dramatically lower than poorly rated hospitals.
In the study, HealthGrades, the nation's leading independent healthcare ratings organization, evaluated the quality of bariatric surgery in hospitals across 19 states that provide all-payer information. The recipient list and full study results can be found at www.healthgrades.com. As other studies have found, high bariatric surgery volumes correlated with better inhospital outcomes. In this study, higher-volume programs, those with greater than 375 cases over three years, have a 32 percent lower risk of patient complications than lower volume programs, those with less than 75 cases over three years.
AdvertisementCalifornia was, on average, the most expensive state for bariatric surgery, with an average charge per procedure of $52,224, the study found. Maryland was the least expensive with an average charge per procedure of $14,577.
Bariatric surgery is a general term describing several types of weight loss procedures. The HealthGrades study analyzed the outcomes of the most common including gastric bypass procedures, less invasive laparoscopic procedures including gastric banding, malabsorbtive procedures and combined malabsorbtive/restrictive procedures.
Due to the growing number of obese Americans and the explosion of bariatric surgery programs in the U.S., patients have many choices when it comes to selecting a program. This study has found a wide variation in the quality and outcomes of these programs. Because bariatric surgery is an elective procedure, patients have the time to thoroughly investigate their surgeon and hospital before making a decision on where to have surgery performed.
"Due to the wide gap in quality we see among bariatric surgery programs, we encourage patients to carefully evaluate the volume and inhospital outcomes of the bariatric program they are considering," said Rick May, MD, a senior physician consultant with HealthGrades and a co-author of the study. "Hospitals designated as five-star for bariatric surgery have best practices that drive their exceptional outcomes."
Other findings identified in the study include:
- Bariatric surgery patients treated at top-rated hospitals have, on average a 67 percent lower chance of experiencing serious complications compared to patients who receive treatment at poorly rated hospitals.
- Patients having surgery at five-star hospitals spent, on average, more than half a day less in the hospital (2.15 days) compared to patients having surgery in one-star hospitals (2.72 days).
- Of the 19 states studies, over 61% of all procedures were performed in five states: New York, Texas, Pennsylvania, California and Florida.
- Patients in Vermont, on average, spent the most time in the hospital (3.26 days), while patients in Nevada, on average, spent the least amount of time in the hospital (1.56 days).
- The number of inpatient procedures during the study years 2005 through 2007 showed no significant increase, but an increasing percentage of surgeries are being performed outpatient.
- More Center of Excellence bariatric surgery programs earned a five-star rating (29.5%) than non-COE programs (12.3%).
- Laparospcopic bariatric surgery procedures account for 79% of all procedures, up from 54% in last year's study.
- Patients had a three times lower inhospital death rate associated with a bariatric surgery if they had it performed at a five-star hospital versus a one-star hospital.
MethodologyFor this study, HealthGrades analyzed 153,355 bariatric procedures performed in the years 2005, 2006 and 2007. The states included in the study are: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin.
To make accurate and valid comparisons of clinical outcomes at different hospitals with different patient characteristics, HealthGrades risk adjusted the data using multivariate logistic regression to account for age, gender and underlying medical conditions that could increase the patient's risk of mortality or complication. The full study and individual hospital ratings for bariatric surgery and other procedures can be found at www.healthgrades.com.