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Factors Associated With Long Wait Times for Bariatric Surgery
Rafael Alvarez1, Aaron J Bonham1,2, Colleen M Buda1
1Department of Surgery, University of Michigan, Ann Arbor, MI.
Annals of Surgery
|May 26, 2018
Summary
Wait times for bariatric surgery are increasing, with patients facing longer delays. Medicaid insurance, sleep apnea, and psychological disorders are linked to longer waits, despite similar outcomes.
Area of Science:
- Medical research
- Surgical outcomes
- Public health policy
Background:
- Bariatric surgery is safe and effective but underutilized for severe obesity.
- Wait times for bariatric surgery in the U.S. are not well understood and may affect patient access.
- Investigating wait times is crucial for improving care for severe obesity.
Purpose of the Study:
- To quantify the time from initial bariatric surgery consultation to the operative date.
- To identify patient-related factors associated with prolonged wait times for bariatric surgery.
Main Methods:
- A statewide clinical data registry was analyzed for 60,791 patients undergoing primary bariatric surgery (2006-2016).
- Demographics, comorbidities, and outcomes were compared between shortest and longest wait time quartiles.
- Statistical analyses included Chi-square, t-tests, and logistic regression.
Main Results:
- Median wait times increased from 86 to 159 days between 2006 and 2016.
- Longer wait times (≥204 days) were associated with Medicaid insurance, sleep apnea, psychological disorders, hyperlipidemia, smoking history, and white race.
- Key factors like preoperative weight loss, complication rates, and postoperative outcomes were similar across wait time groups.
Conclusions:
- Eligible patients face increasing delays for bariatric surgery over the last decade.
- Patients with Medicaid insurance and complex conditions experience the longest delays, yet achieve similar results.
- Current policies contributing to surgical delays require re-evaluation to ensure equitable access to care.
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