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Study finds bariatric surgery growing; quality, safety disparities noted


By Maureen McKinney
Posted: May 26, 2010 - 12:15 am ET
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The number of bariatric surgeries being performed in the U.S. continues to rise, but the quality and safety of these procedures varies widely from one hospital to another, according to a newly released study.

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In its fifth annual study of bariatric surgery trends, Golden, Colo.-based HealthGrades assessed more than 190,000 bariatric surgery discharges from 684 hospitals in 19 states from 2006 through 2008. Researchers used that data to assign hospitals one of three ratings to indicate best-, average- and poor-performing facilities—a ranking that was significantly affected by the volume of bariatric surgeries hospitals performed each year.

Overall rates of risk-adjusted, in-hospital complications and mortality related to obesity surgery are decreasing, according to the study. But researchers also reported large performance gaps among facilities. For instance, bariatric surgery mortality, while uncommon, occurred at one-fourth the rate at top-performing hospitals vs. bottom-performing, or 0.03% versus 0.12%.

Patients at top hospitals had a 66.55% lower chance of experiencing complications than patients who underwent bariatric surgery at a bottom-ranked hospital, and they also had shorter lengths of stay. Based on the available data, researchers concluded that if all bariatric programs performed at the level of the top-ranked hospitals during the three-year period, 5,046 patients could have avoided major in-hospital complications.

“Bariatric surgery has been proven to reduce caloric intake and control obesity, but the HealthGrades study demonstrates that where patients have this type of surgery matters—a great deal,” Rick May, HealthGrades' vice president of clinical consulting and a co-author of the study, said in a news release. “There is a subset of U.S. hospitals whose patients, the data show, have fewer complications and leave the hospital earlier.”

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