Bariatric Surgery Outcomes No Better at Centers of Excellence
(HealthDay News) – The Centers for Medicare and Medicaid Services (CMS) policy restricting coverage of bariatric surgery to hospitals designated as centers of excellence (COEs) has not been associated with an improvement in bariatric surgery outcomes, according to a study published in the Feb. 27 issue of the Journal of the American Medical Association.
To examine whether improved bariatric surgery outcomes among Medicare patients correlated with the CMS restriction of coverage of bariatric surgery to hospitals designated as COEs, Justin B. Dimick, MD, MPH, from the University of Michigan in Ann Arbor, and colleagues conducted a longitudinal study involving hospital discharge data for 2004–2009 from 321,464 patients. Outcomes were compared for Medicare patients undergoing surgery before (6,723 patients) and after (15,854 patients) implementation of the policy in 2006.
The researchers found that bariatric surgery outcomes improved in Medicare and non-Medicare patients, and the improvement started before the CMS coverage decision. There were no significant improvements in outcome after versus before implementation of the CMS coverage decision for any complication, serious complications, or reoperation, after adjustment for patient factors, changes in procedure type, and preexisting time trends toward improved outcomes. There was no significant difference in any complications, serious complications, or reoperation, in a direct assessment comparing hospitals designated as COEs and those not designated as COEs.
"Combined with prior studies showing no association of COE designation and outcomes, these results suggest that Medicare should reconsider this policy," the authors write.
Two authors disclosed financial ties to ArborMetrix.