Bariatric Surgery Complication Rates High In Some Hospitals
Bariatric Surgery Safety
In-hospital bariatric surgery complication rates vary dramatically among the nation's hospitals, according to a study released today by HealthGrades, the leading healthcare ratings company. The study of 86,520 bariatric-surgery procedures performed over the years 2002 through 2004 finds that a typical patient receiving the procedure in a five-star rated hospital would have, on average, a 66 percent lower chance of developing one or more major inhospital complications compared with a one-star rated hospital.
Based on the study, HealthGrades, for the first time, today posted quality ratings for hospitals in 17 states that perform bariatric surgery on its consumer Web site, HealthGrades.com. Hospitals received a five-, three- or one-star rating that reflected their complication rates for bariatric surgery, also known as weight-loss surgery, obesity surgery and gastric-bypass surgery.
The HealthGrades study comes on the heels of a study published in July by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality, which found that four of every ten patients undergoing bariatric surgery develop complications within six months.
The percentage of U.S. adults who are obese has doubled in the last thirty years, reaching 30 percent according to the CDC's National Center for Health Statistics. The number of bariatric surgeries in America are increasing dramatically as well, with the volume growing 34 percent from 2002 to 2004 in the 17 states studied. Experts attribute a growing proportion of the nation's healthcare bill to overweight and obesity, reaching 9.1 percent of U.S. medical costs, or $78 billion, in the most recent study.
The first annual HealthGrades Bariatric Surgery Trends in American Hospitals Study found that:
- Higher volume programs have better quality. Hospitals rated by HealthGrades with five stars for bariatric surgery had, on average, twice the number of procedures during the three-year study period compared to one-star rated hospitals (388 and 195, respectively);
- High quality programs have shorter hospital stays. The average length of stay was 21 percent shorter in five-star hospitals, as compared with the national average;
- If all hospitals performed at the level of a five-star rated hospital, 3,297 out of the 86,520 patients studied could have potentially avoided one or more major inhospital complications;
- The most common major complications include respiratory, bleeding, and cardiac complications;
- The average U.S. mortality rate during the study period was 0.19 percent, or two patients per 1000;
- Half of all the procedures were performed in just four states - New York, Florida, Texas and Pennsylvania - although those states comprise 42 percent of the population of the 17 states studied; and
- Iowa, Maryland and Wisconsin had the largest growth in numbers of procedures performed, with almost twice as many cases in 2004 compared to 2002.
"It is predicted that more than 200,000 bariatric surgeries will be performed in 2006, but this study shows very clearly that not all hospitals perform the procedure with the same level of quality," said Samantha Collier, MD, HealthGrades senior vice president of medical affairs. "That's to be expected in a relatively new procedure that has grown so quickly in recent years, but it makes it necessary for consumers to carefully research the track record of hospitals before having the procedure performed."
Individuals contemplating bariatric surgery will find both quality and cost information at HealthGrades.com. In addition to the free quality ratings of bariatric surgery at hospitals in 17 states, Web site visitors can also research surgeons who perform bariatric surgery to find the one that is right for them. Medical-cost reports that detail all of the costs, including out-of-pocket expenses, for the procedure, are also available on HealthGrades.com.
For this study, HealthGrades analyzed 86,520 bariatric procedures performed in the years 2002, 2003 and 2004. To make accurate and valid comparisons of clinical outcomes at different hospitals with different patient characteristics, HealthGrades risk adjusted the data using multivariate logistic regression-based ratings to account for age, gender and underlying medical conditions that could increase the patient's risk of mortality or complication.
To conduct its study, HealthGrades used all-payer data from the 17 state government agencies that collect it from hospitals and release it for analysis.