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Restrictions on Bariatric Surgery Affects Access for the Poor
October 31, 2007 at 6:17 PM
General Health News
Government-imposed restrictions currently mandate a 125-case annual threshold for facilities permitted to perform bariatric surgeries under Medicare and Medicaid because some studies have identified better outcomes for centers performing large volumes of bariatric surgeries. But most bariatric surgeries for the poor about 60 percent are performed in low-volume centers.
Restricting surgeries to high-volume centers has the effect of limiting bariatric surgery as an option for many poor and underinsured who rely on Medicare and Medicaid, said Dr. Edward Livingston, senior author of the study appearing in the October edition of Archives of Surgery. This is a population that stands to gain the most from bariatric surgery.
Dr. Livingston is chairman of gastrointestinal and endocrine surgery at UT Southwestern and chairman of the Veterans Administration Central Office Bariatric Surgery Work Group.
Nearly three quarters of hospitals offering bariatric surgery are considered low-volume facilities under the 125-case threshold, thereby leaving few centers available for impoverished populations.
Yet low-income patients, particularly those in rural areas, may not be able to travel to the limited number of high-volume centers due to costs such as gas, access to public transportation or personal vehicles, or health matters that limit their travel, Dr. Livingston said.
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