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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
5010.0: Wednesday, December 14, 2005 - Board 2

Abstract #121551

Weight Loss Surgery in the United States, 1995-2003

Chetna Mehrotra, MPH, Centers for Disease Control, Division of Nutrion and Physical Actvity, P.O.BOx 465, Zuni, NM 87327, 5057822929, bfz1@cdc.gov, Timothy S. Naimi, MD, MPH, Division of Adult and Community Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-67, Atlanta, GA 30341, and Mary K. Serdula, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K-26, Atlanta, GA 30341.

Abstract Objective: To assess trends in weight loss surgery (WLS) and associated charges in the U.S., and to assess characteristics of WLS recipients. Context: The increase in morbid obesity has created increased demand for weight reduction interventions. However, few population-based studies have assessed trends in WLS procedure, the characteristics of those undergoing WLS, or WLS-related hospital charges. . Methods: We analyzed data from the Nationwide Inpatient Sample (NIS) from 1995-2002. NIS data was weighted to represent the U.S. population. Results: Between 1995 and 2003, the number of WLS procedures in the U.S increased from 7,592 to 119,443 (rate ratio 12.4, p value <0.001). Throughout the study period, the largest number of WLS procedures were performed on women, relatively young adults (ages 50-59), and whites; most of these procedures were performed in urban academic hospitals. However, the largest increases in WLS were observed among non-traditional patients (men, older individuals, racial and ethnic minorities, and those with multiple obesity-related comorbidities), and increasing number of these surgeries were performed in rural, non-academic facilities. During the study period, inflation-adjusted total charges for WLS increased from approximately $200 million to $2 billion. This corresponded to an increase of 32% in the inflation-adjusted average charge per procedure, despite a decline in the average length of stay from 6 to 3 days. Charges covered for WLS increased across all payer types, including an increase of 990% for private insurers and 629% for Medicaid. Conclusions: During the past decade, there has been an exponential increase in WLS procedures, which are being performed on a wider range of patients in more diverse clinical settings; during this time inflation-adjusted charges exceeded even the increase in the procedures themselves. Given these trends, it seems likely that the impact of WLS on health care and health care financing will continue to grow.

Learning Objectives:

Keywords: Obesity, Treatment Patterns

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

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The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA