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Bariatric surgery implementation trends in the USA from 2002 to 2012
Emily E Johnson1, Annie N Simpson2, Jillian B Harvey3
1College of Nursing, Medical University of South Carolina, Room 414, 99 Jonathan Lucas Street, Charleston, SC, 29425, USA. johnsoem@Musc.edu.
Implementation Science : IS
|February 22, 2016
Summary
The diffusion of bariatric surgery slowed over time, influenced by factors like older populations and cumulative surgeries. However, the presence of Medicare Centers of Excellence accelerated its adoption, highlighting key drivers for healthcare innovation.
Area of Science:
- Healthcare Innovation Diffusion
- Surgical Intervention Adoption
- Health Services Research
Background:
- Effective healthcare interventions often face challenges in implementation and widespread adoption due to complex contextual factors.
- Bariatric surgery, a proven intervention, has shown a concerning plateau and decrease in utilization rates without clear justification.
- Existing conceptual models for innovation diffusion lack empirical testing for specific healthcare interventions like bariatric surgery.
Purpose of the Study:
- To analyze the factors influencing the diffusion of bariatric surgery over time.
- To test a conceptual model of healthcare innovation diffusion using empirical data.
- To identify facilitators and impediments to bariatric surgery adoption.
Main Methods:
- Conducted a literature review to identify factors affecting healthcare innovation implementation and diffusion.
- Developed a conceptual diffusion model for bariatric surgery.
- Utilized six data sources to measure population and model factors for bariatric surgery from 2002-2012 in 15 states.
- Employed multivariable models to assess environmental, population, and medical practice factors impacting diffusion.
Main Results:
- Bariatric surgery rates increased, but the pace of diffusion (growth rate) slowed over the study period.
- Factors such as a higher cumulative number of surgeries and a larger proportion of the population aged 50-59 years impeded diffusion.
- The presence of Medicare Centers of Excellence significantly accelerated the diffusion of bariatric surgery.
Conclusions:
- The presence of Centers of Excellence was the primary driver for bariatric surgery diffusion.
- Higher cumulative surgery rates and older population demographics acted as barriers to diffusion.
- The developed conceptual model provides a framework for understanding and potentially enhancing the diffusion of healthcare innovations for improved outcomes.
