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Adolescent Bariatric Surgery: Effects of Socioeconomic, Demographic, and Hospital Characteristics on Cost, Length of Stay, and Type of Procedure Performed

  • Claire B. Cummins
  • Omar Nunez Lopez
  • Byron D. Hughes
  • Deepak Adhikari
  • Christopher A. Guidry
  • Samantha Stubbs
  • Ravi S. Radhakrishnan
  • Kanika A. Bowen-Jallow
Original Contributions
  • 46 Downloads

Abstract

Background

Despite the efficacy of bariatric surgery in adolescents and the increasing rates of adolescent obesity, the use of bariatric surgery remains low. Treatment cost and length of stay (LOS) could be influencing the utilization of bariatric surgery.

Methods

We used the Kids’ Inpatient Database (KID) from 2006, 2009, and 2012. Adolescents with a primary diagnosis of obesity who underwent bariatric surgery were included. Multinomial logistic and linear regression modeling was used to determine the association of the predictor variables with type of procedure and treatment cost and LOS, respectively.

Results

We identified 1799 adolescents who underwent bariatric surgery. The majority of the subjects were female (77%) and White (60%). The most commonly performed procedure was Roux-en-Y gastric bypass (56%). Race, region, hospital teaching status, and hospital ownership affected the type of procedure performed. Self-pay patients were less likely to undergo Roux-en-Y gastric bypass (RYGB) than sleeve gastrectomy (SG) when compared to patients with private insurance. Teaching hospitals were less likely to perform RYGB or AGB than SG when compared to non-teaching hospitals. Treatment cost was significantly affected by income, teaching hospital status, hospital size, and surgery type. LOS was affected by income quartile, region, and surgery type.

Conclusion

Socioeconomic and demographic factors as well as hospital characteristics affect not only the LOS and treatment cost, but also the type of bariatric surgery performed in adolescents. Identifying and understanding the factors influencing procedure choice, treatment cost, and LOS can improve care and healthcare resource utilization.

Keywords

Bariatric surgery Adolescent obesity Childhood obesity Length of stay Treatment cost 

Notes

Funding Information

This publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number T32DK007639.

Compliance with Ethical Standards

This study was considered non-human subjects research due to the use of nationally available de-identified data and, therefore, was deemed exempted by the institution’s Institutional Review Board.

Conflict of Interest

The authors declare that no conflicts of interest exist.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Claire B. Cummins
    • 1
  • Omar Nunez Lopez
    • 1
  • Byron D. Hughes
    • 1
  • Deepak Adhikari
    • 2
  • Christopher A. Guidry
    • 1
  • Samantha Stubbs
    • 1
  • Ravi S. Radhakrishnan
    • 1
    • 3
  • Kanika A. Bowen-Jallow
    • 1
    • 3
  1. 1.Department of SurgeryUniversity of Texas Medical BranchGalvestonUSA
  2. 2.Center for Gerontology and Healthcare ResearchBrown UniversityProvidenceUSA
  3. 3.Division of Pediatric SurgeryUniversity of Texas Medical BranchGalvestonUSA

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