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Major Finding: The complication rate for cholecystectomy was 21% for obese patients and 16.5% for nonobese. For appendectomy, the complication rate was 21% for obese patients and 18.8% for nonobese patients.
Data Source: A review of the insurance claims of 36,483 patients included in seven Blue Cross/Blue Shield databases.
Disclosures: None reported.
NEW ORLEANS — Obese patients have a significantly increased risk of complications after cholecystectomy and appendectomy, which drives up the costs of these common procedures.
Because insurance companies are footing the bill, any move to institute pay-for-performance policies could work against obese patients, Dr. Kenzo Hirose said at the annual Digestive Disease Week.
If pay-for-performance is adopted based on outcomes, providers would be paid less for patients at risk of complications, said Dr. Hirose of Johns Hopkins Hospital, Baltimore. “Hospitals that have a higher burden of patients at a high risk of obesity—blacks, Hispanics, inner-city patients, and those at a lower socioeconomic status—could actually end up being penalized for caring for them.”
Dr. Hirose and his colleagues reviewed insurance claims for cholecystectomy and appendicitis in seven Blue Cross/Blue Shield databases for the period 2002–2006. For each procedure, they compared 30-day complication rates and total direct medical costs for inpatient surgery.
Cholecystectomy for cholecystitis was performed on 31,028 patients, and another 5,455 patients underwent appendectomy for acute appendicitis. For both procedures, obese patients had a significantly greater complication rate and significantly higher costs than did nonobese patients.
The mean complication rate for cholecystectomy was 21% for obese patients and 16.5% for nonobese. The mean cost was $2,000 less in nonobese patients ($16,992 vs. $18,653).
For appendectomy, the mean complication rate was 21% for obese patients and 18.8% for nonobese patients. The mean cost was $1,220 more for obese patients ($15,400 vs. $14,180).
Surgical site infections constituted most of the complications. The differences in complication rates remained significant even after the researchers controlled for diabetes, hypertension, dyslipidemia, and obstructive sleep apnea.
“What sounds good in theory turns out in reality to punish doctors who take care of more high-risk patients and actually financially incentivizes discrimination,” lead study author Dr. Martin Makary said in a statement.
Surgical site infections constituted most of the complications.
Source DR. HIROSE
Major Finding: The complication rate for cholecystectomy was 21% for obese patients and 16.5% for nonobese. For appendectomy, the complication rate was 21% for obese patients and 18.8% for nonobese patients.
Data Source: A review of the insurance claims of 36,483 patients included in seven Blue Cross/Blue Shield databases.
Disclosures: None reported.
NEW ORLEANS — Obese patients have a significantly increased risk of complications after cholecystectomy and appendectomy, which drives up the costs of these common procedures.
Because insurance companies are footing the bill, any move to institute pay-for-performance policies could work against obese patients, Dr. Kenzo Hirose said at the annual Digestive Disease Week.
If pay-for-performance is adopted based on outcomes, providers would be paid less for patients at risk of complications, said Dr. Hirose of Johns Hopkins Hospital, Baltimore. “Hospitals that have a higher burden of patients at a high risk of obesity—blacks, Hispanics, inner-city patients, and those at a lower socioeconomic status—could actually end up being penalized for caring for them.”
Dr. Hirose and his colleagues reviewed insurance claims for cholecystectomy and appendicitis in seven Blue Cross/Blue Shield databases for the period 2002–2006. For each procedure, they compared 30-day complication rates and total direct medical costs for inpatient surgery.
Cholecystectomy for cholecystitis was performed on 31,028 patients, and another 5,455 patients underwent appendectomy for acute appendicitis. For both procedures, obese patients had a significantly greater complication rate and significantly higher costs than did nonobese patients.
The mean complication rate for cholecystectomy was 21% for obese patients and 16.5% for nonobese. The mean cost was $2,000 less in nonobese patients ($16,992 vs. $18,653).
For appendectomy, the mean complication rate was 21% for obese patients and 18.8% for nonobese patients. The mean cost was $1,220 more for obese patients ($15,400 vs. $14,180).
Surgical site infections constituted most of the complications. The differences in complication rates remained significant even after the researchers controlled for diabetes, hypertension, dyslipidemia, and obstructive sleep apnea.
“What sounds good in theory turns out in reality to punish doctors who take care of more high-risk patients and actually financially incentivizes discrimination,” lead study author Dr. Martin Makary said in a statement.
Surgical site infections constituted most of the complications.
Source DR. HIROSE
Major Finding: The complication rate for cholecystectomy was 21% for obese patients and 16.5% for nonobese. For appendectomy, the complication rate was 21% for obese patients and 18.8% for nonobese patients.
Data Source: A review of the insurance claims of 36,483 patients included in seven Blue Cross/Blue Shield databases.
Disclosures: None reported.
NEW ORLEANS — Obese patients have a significantly increased risk of complications after cholecystectomy and appendectomy, which drives up the costs of these common procedures.
Because insurance companies are footing the bill, any move to institute pay-for-performance policies could work against obese patients, Dr. Kenzo Hirose said at the annual Digestive Disease Week.
If pay-for-performance is adopted based on outcomes, providers would be paid less for patients at risk of complications, said Dr. Hirose of Johns Hopkins Hospital, Baltimore. “Hospitals that have a higher burden of patients at a high risk of obesity—blacks, Hispanics, inner-city patients, and those at a lower socioeconomic status—could actually end up being penalized for caring for them.”
Dr. Hirose and his colleagues reviewed insurance claims for cholecystectomy and appendicitis in seven Blue Cross/Blue Shield databases for the period 2002–2006. For each procedure, they compared 30-day complication rates and total direct medical costs for inpatient surgery.
Cholecystectomy for cholecystitis was performed on 31,028 patients, and another 5,455 patients underwent appendectomy for acute appendicitis. For both procedures, obese patients had a significantly greater complication rate and significantly higher costs than did nonobese patients.
The mean complication rate for cholecystectomy was 21% for obese patients and 16.5% for nonobese. The mean cost was $2,000 less in nonobese patients ($16,992 vs. $18,653).
For appendectomy, the mean complication rate was 21% for obese patients and 18.8% for nonobese patients. The mean cost was $1,220 more for obese patients ($15,400 vs. $14,180).
Surgical site infections constituted most of the complications. The differences in complication rates remained significant even after the researchers controlled for diabetes, hypertension, dyslipidemia, and obstructive sleep apnea.
“What sounds good in theory turns out in reality to punish doctors who take care of more high-risk patients and actually financially incentivizes discrimination,” lead study author Dr. Martin Makary said in a statement.
Surgical site infections constituted most of the complications.
Source DR. HIROSE