Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Bariatric surgery complications after implementation of a national policy

A study in this week's issue of the Journal of the American Medical Association investigates bariatric surgery complications before vs after implementation of a National Policy Restricting Coverage to centers of excellence.

News image

Starting in 2006, the Centers for Medicare & Medicaid Services has restricted coverage of bariatric surgery to hospitals designated as centers of excellence by 2 major professional organizations.

Dr Justin Dimick and colleagues evaluated whether the implementation of the centers of excellence component of the national coverage decision was associated with improved bariatric surgery outcomes in Medicare patients.

The team performed a retrospective, longitudinal study using 2004-2009 hospital discharge data from 12 states of changes in outcomes in Medicare patients undergoing bariatric surgery.

Bariatric surgery outcomes improved during the study period
Journal of the American Medical Association

A difference-in-differences analytic approach was used to evaluate whether the national coverage decision was associated with improved outcomes in Medicare patients above and beyond existing time trends in non-Medicare patients.

The research team's main outcome measures included risk-adjusted rates of any complication, serious complications, and reoperation.

Bariatric surgery outcomes improved during the study period in both Medicare and non-Medicare patients.

The team reported that this change was already under way prior to the Centers for Medicare & Medicaid Services coverage decision.

After accounting for patient factors, changes in procedure type, and preexisting time trends toward improved outcomes, there were no statistically significant improvements in outcomes after implementation of the CMS national coverage decision for any complication, serious complications, and reoperation.

In a direct assessment comparing outcomes at hospitals designated as centers of excellence vs hospitals without the centers of excellence designation, the team found no significant differences for any complication, serious complications, and reoperation.

Dr Dimick's team concludes, "Among Medicare patients undergoing bariatric surgery, there was no significant difference in the rates of complications and reoperation before vs after the CMS policy of restricting coverage to centers of excellence."

"Combined with prior studies showing no association of centers of excellence designation and outcomes, these results suggest that Medicare should reconsider this policy."

JAMA 2013; 309(8): 792-799
05 March 2013

Go to top of page Email this page Email this page to a colleague

 04 March 2015

Advanced search
 04 March 2015 
Progression of Barrett's
 04 March 2015 
Multidisciplinary management of rectal cancer
 04 March 2015 
Management of IBD
 03 March 2015 
Risk of anastomotic leak after colectomy
 03 March 2015 
GI bleeding in chronic kidney disease patients on aspirin
 03 March 2015 
EPHX1 polymorphism and esophageal cancer risk
 02 March 2015 
Liver disease in patients awaiting liver transplant
 02 March 2015 
Genes and early diagnosis of IBD
 02 March 2015 
Assessment of GERD
 27 February 2015 
Obesity and weight-loss therapy
 27 February 2015 
MRE performance in staging liver fibrosis
 27 February 2015 
Bleeding in diverticulosis
 26 February 2015 
Familial colorectal cancer risk and primary cancer
 26 February 2015 
Herbal products and the liver
 26 February 2015 
Questionnaires for GERD
 25 February 2015 
Exercise and NAFLD
 25 February 2015 
IBD in Korea
 25 February 2015 
Immunosuppressive therapy and T. whipplei
 24 February 2015 
Clinical trials in pediatric IBD
 24 February 2015 
Reducing health care costs in IBD
 24 February 2015 
GI bleeding after anticoagulation interruption
 23 February 2015 
Visceral abdominal obesity and IBS
 23 February 2015 
Crohn's outcomes with infliximab
 23 February 2015 
Intestinal microbiota and celiac disease
 20 February 2015 
H. pylori eradication
 20 February 2015 
Antiviral treatment and Hep C outcomes
 20 February 2015 
C. diff testing in IBD
 19 February 2015 
Intestinal microbiota in IBS
 19 February 2015 
Peptic ulcer bleeding mortality in liver disease
 19 February 2015 
Fecal microbial transplant in active Crohn's disease
 18 February 2015 
Genetic testing and GI cancers
 18 February 2015 
Placebo analgesia in functional abdominal pain
 18 February 2015 
Successful Hep C virus therapy
 17 February 2015 
Quality measures and colonoscopist selection
 17 February 2015 
Global incidence of esophageal cancer
 17 February 2015 
Anti-viral treatment and survival in Hep C
 16 February 2015 
Saliva for the diagnosis of GERD
 16 February 2015 
H pylori eradication therapy
 16 February 2015 
Medical marijuana for digestive disorders
 13 February 2015 
Prevalence of microscopic colitis
 13 February 2015 
Beta-blockers in cirrhosis
 13 February 2015 
Liver disease and peptic ulcer bleeding
 12 February 2015 
Liver disease in chronic Hep C
 12 February 2015 
Patient-reported outcomes in Hep C
 12 February 2015 
Patientsí colonoscopist selection
 11 February 2015 
Hepatic decompensation in Hep C cirrhosis
 11 February 2015 
Guidelines for the diagnosis of hepatocellular carcinoma
 11 February 2015 
NAFLD and CVD
 10 February 2015 
Percutaneous endoscopic gastrostomy
 10 February 2015 
Factors that influence hepatic steatosis
 10 February 2015 
Gene variants and Crohn's susceptibility
 09 February 2015 
Factors that influence gallstone surgery
 09 February 2015 
Factors associated with increased mortality in cirrhosis
 09 February 2015 
Use of immunomodulators in IBD
 06 February 2015 
Colorectal cancer risk in IBD
 06 February 2015 
H. pylori and peptic ulcer bleeding
 06 February 2015 
IBS and somatization
 05 February 2015 
GERD, dyspepsia and IBS symptoms
 05 February 2015 
Thalidomide and refractory Crohn's
 05 February 2015 
Quality of life in Crohn's after antitumor necrosis factor agents

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us