Surgical options have emerged as effective treatments to mitigate obesity-associated co-morbidities leading to reduced mortality risk. Despite the benefits of bariatric surgery, a low portion of the eligible population undergoes weight loss procedures.
To determine if regional disparities exist among bariatric patients in the United States and potential effects of any difference SETTING: National Inpatient Sample (NIS).
We performed a retrospective, cross-sectional analysis of the NIS database from 2003-2010. We identified 4 regions of the United States; Northeast, Midwest, West, and South. Endpoints included race, payor status, co-morbidities, urban/rural areas, institutional academic status, surgeon, and institutional volume. The sample was analyzed using χ(2) tests, linear regression, and multivariate logistical regression analysis.
A total of 132,342 cases and 636,320 controls were studied. A majority of the study population was female (62.5%) and white (70.0%) with private insurance (42.0%). The highest prevalence of obesity was identified in the South (39.7%) and the lowest in the Midwest (17.1%). The greatest numbers of bariatric procedures are performed in the Northeast (24.4%) compared with the South (13.9%) and Midwest (13%). After controlling for demographic characteristics, the proportion of procedures performed in the Northeast compared with the South (odds ratio .52, confidence interval .40-.66; P<.001) and Midwest (odds ratio .50, confidence interval .33-.75; P<.005) was significant.
Significant disparities in bariatric procedures performed were identified in the South and Midwest regions compared with the Northeast. Although the South has a higher prevalence of obesity, thus it could be suggested by outreach programs.