A new study published in JAMA which compared the rates of bariatric (weight-loss) surgery for minority Medicare and non-Medicare patients before and after implementation of a Medicare coverage policy reveals that the safety measures that are intended to improve surgery outcomes may instead impede obese minorities' access to care.
Led by faculty from the Johns Hopkins Bloomberg School of Public Health, the researchers found a decline in the number of minority patients with Medicare receiving bariatric surgery after the policy was implemented.
Obesity
Obesity is a condition where there is excess accumulation of body fat which poses a risk to the health of the individual. It can affect children and adults.
Advertisement
"The Medicare centers of excellence policy was associated with a 4.7 percentage point (17 percent) decline in the proportion of Medicare patients receiving bariatric surgery who were non-white," said Lauren Hersch Nicholas, PhD, MPP, lead author of the letter and an assistant professor with the Bloomberg School's Department of Health Policy and Management. "It appears that a policy intended to improve patient safety had the unintended consequence of reduced use of bariatric surgery by minority Medicare patients."
Hospitals are recognized as centers of excellence if they submitted data to a registry, have adequate protocols for care of morbidly obese patients, and perform at least 125 bariatric procedures annually. Researchers examined bariatric surgery discharge abstracts from 228,136 patients undergoing bariatric surgery in 429 inpatient hospitals in 8 states and compared the proportion of minority patients undergoing bariatric surgery with and without Medicare before and after implementation of the policy change. Non-Medicare patients were used as a control group to isolate associations with the Medicare policy change relative to trends among all bariatric surgeries over the study period. In addition, researchers compared the number of white patients with those from all other minority groups.
![Childhood Obesity]( "Childhood Obesity")
Childhood obesity is one of the most serious health challenges in the developing countries and needs to be understood and tackled effectively.
Earlier studies documenting better surgical outcomes at hospitals with higher procedure volume have prompted proposals to concentrate elective surgery in high-volume settings; these policies have been little-used in practice. To date, bariatric surgery is the only procedure for which the Centers for Medicare and Medicaid Services (CMS) have experimented with restrictions to high-volume hospitals. CMS recently proposed eliminating the centers of excellence requirement after studies suggested little if any safety benefit to bariatric centers of excellence and is expected to issue a decision later this month.
"Policies restricting patients to centers of excellence could lead to serious issues including, reducing access for vulnerable populations," suggest the authors.
"Morbidity and mortality associated with bariatric surgery have declined in recent years and safety gains from limiting hospital choice are likely lower than they were when the national coverage decision was implemented in 2006," adds Nicholas. "Our findings are important for bariatric surgery and also serve as a cautionary tale about the potential for unintended consequences if selective referral policies are extended to other procedures."
Source: Eurekalert
Childhood Obesity
Childhood obesity is one of the most serious health challenges in the developing countries and needs to be understood and tackled effectively.
Advertisement
Earlier studies documenting better surgical outcomes at hospitals with higher procedure volume have prompted proposals to concentrate elective surgery in high-volume settings; these policies have been little-used in practice. To date, bariatric surgery is the only procedure for which the Centers for Medicare and Medicaid Services (CMS) have experimented with restrictions to high-volume hospitals. CMS recently proposed eliminating the centers of excellence requirement after studies suggested little if any safety benefit to bariatric centers of excellence and is expected to issue a decision later this month.
"Policies restricting patients to centers of excellence could lead to serious issues including, reducing access for vulnerable populations," suggest the authors.
"Morbidity and mortality associated with bariatric surgery have declined in recent years and safety gains from limiting hospital choice are likely lower than they were when the national coverage decision was implemented in 2006," adds Nicholas. "Our findings are important for bariatric surgery and also serve as a cautionary tale about the potential for unintended consequences if selective referral policies are extended to other procedures."
Source: Eurekalert
Mantra to Prevent Childhood Obesity – Vigorous Physical Activity
Being physically very active is the mantra to prevent pediatric obesity rather than concentrating efforts at restricting energy consumption.
Advertisement
 Atkins DietAtkins diet is a low carbohydrate diet and aids in weight loss. It was developed by Robert Atkins. | Advertisement
|
Advertisement
Recommended Readings
Latest Weight Loss
Almonds, advised for calorie-restricted diets for obesity or overweight , assisted in both weight loss and better cardio-metabolic health.
The best time of day to engage in moderate to vigorous physical activity for weight loss and obesity is between 7am to 9am.
Researchers aim to uncover the neural circuitry responsible for the rise in appetite induced by cold temperatures.
Consuming kale, regardless of its stage of maturity, increases the diversity of gut bacteria. However, this enhancement is more noticeable with microgreens.
The heart rate and intensity at which the body burns fat during aerobic exercise varies for each person, highlighting the need for a more personalized approach.
