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Bariatric patients have 65% lower chance of complications at top hospitals: HealthGrades study
July 29, 2008Bariatric surgery patients treated at highly rated hospitals have, on average, a 65 percent lower chance of experiencing serious complications compared to patients who undergo surgery at poorly rated hospitals according to a study released today by HealthGrades, the nations leading independent healthcare ratings organization. As part of the study, the quality ratings of hospitals performing bariatric surgery in 17 states became available today at www.healthgrades.com.
HealthGrades' third annual Bariatric Surgery Trends in American Hospitals study, which evaluated bariatric surgical outcomes at every hospital that performed them in 17 states, also found that the complication rate for these surgeries continues to rise, increasing six percent from 2004 to 2006. One possible reason: lower volume facilities have higher complication rates.
Bariatric surgery is a general term describing several types of weight loss procedures. HealthGrades study analyzed the outcomes of the most common, including traditional open surgical gastric bypass procedures as well as newer, less invasive procedures such as "lap-banding" and laparoscopic gastric bypass.
Complications associated with gastric bypass surgery accounted for the highest rise in complications, increasing 17 percent. Comparatively, complications from less invasive laparoscopic surgery increased by just more than one percent. Complications associated with bariatric surgery include heart attack, kidney failure, stroke and post-surgical infections.
The HealthGrades study found a significant shift toward laparoscopic bariatric procedures. From 2004 through 2006, open gastric bypass procedures declined by 81.82 percent while during the same time period laparoscopic procedures increased 418.86 percent.
Meanwhile, the total volume of bariatric surgical procedures in the U.S. continues to grow rapidly. The American Society for Bariatric Surgery estimates that such surgeries have increased 1,431 percent in the last decade to more than 250,000 annually.
"The tremendous variation we are seeing in quality among bariatric surgery providers underscores the importance of readily available quality data to help consumers make a truly informed decision about where to seek care," said Rick May, MD, a senior physician advisor with HealthGrades and an author of the study.
Additionally, the third annual HealthGrades Bariatric Surgery Trends in American Hospitals study found that:
* A typical patient having a bariatric surgical procedure at a five-star rated hospital in one of the 17 states studied has on average, a 65 percent lower chance of experiencing one or more inhospital complications than at a one-star rated hospital and a 41 percent lower chance than at a three-star rated hospital during 2004- 2006.
* Five-star (top rated) hospitals performed almost twice the volume of procedures compared to 1-star and 3-star facilities-an average of 526 procedures from 2004 through 2006 compared with 266 and 283 respectively.
* Higher volume was associated with fewer risk-adjusted complications. Facilities with an annual case volume of 125 procedures had the lowest risk-adjusted complications. Facilities performing less than 25 cases per year had the highest rate of risk-adjusted complications.
* If all patients had received their bariatric surgery procedure at 5-star hospitals (from 2004 through 2006), 5,125 inhospital complications could have been potentially avoided in the 17 states studied.
HealthGrades Bariatric Surgery Ratings
HealthGrades' quality ratings for bariatric surgery at individual hospitals in 17 states were posted today to www.healthgrades.com as a free resource for consumers. Each hospital receives a star rating based on their patient outcomes for bariatric surgery. Hospitals with above-average outcomes receive a five-star rating. Hospitals with average outcomes receive a three-star rating, and hospitals with outcomes that are below average receive a one-star rating.
The study included a total of 154,451 bariatric inpatient surgery procedures performed in 680 hospitals in 17 states from 2004 through 2006. The majority of procedures were performed in four states: New York, Texas, Pennsylvania, and California.
* 93 hospitals stand out as "best" performers (5-star rated)
* 263 hospitals were rated as "as expected" performers (3-star rated)
* 99 hospitals were rated as "poor" performers (1-star rated)
Individuals contemplating bariatric surgery will find both quality and cost information at www.healthgrades.com. In addition to the free hospital-quality ratings, Web site visitors can also research surgeons who perform bariatric surgery as well as medical-cost reports that detail all of the costs, including out-of-pocket expenses, for the procedure.
Methodology
For this study, HealthGrades analyzed 154,451 bariatric procedures performed in the years 2004, 2005 and 2006. The states included in the study are: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, Texas, Utah, Virginia, Washington, Wisconsin
To make accurate and valid comparisons of clinical outcomes at different hospitals with different patient characteristics, HealthGrades risk adjusted the data using multivariate logistic regression to account for age, gender and underlying medical conditions that could increase the patient's risk of mortality or complication. The full study and individual hospital ratings for bariatric surgery and other procedures can be found at www.healthgrades.com.
HealthGrades
Complications associated with gastric bypass surgery accounted for the highest rise in complications, increasing 17 percent. Comparatively, complications from less invasive laparoscopic surgery increased by just more than one percent. Complications associated with bariatric surgery include heart attack, kidney failure, stroke and post-surgical infections.
The HealthGrades study found a significant shift toward laparoscopic bariatric procedures. From 2004 through 2006, open gastric bypass procedures declined by 81.82 percent while during the same time period laparoscopic procedures increased 418.86 percent.
Meanwhile, the total volume of bariatric surgical procedures in the U.S. continues to grow rapidly. The American Society for Bariatric Surgery estimates that such surgeries have increased 1,431 percent in the last decade to more than 250,000 annually.
"The tremendous variation we are seeing in quality among bariatric surgery providers underscores the importance of readily available quality data to help consumers make a truly informed decision about where to seek care," said Rick May, MD, a senior physician advisor with HealthGrades and an author of the study.
Additionally, the third annual HealthGrades Bariatric Surgery Trends in American Hospitals study found that:
* A typical patient having a bariatric surgical procedure at a five-star rated hospital in one of the 17 states studied has on average, a 65 percent lower chance of experiencing one or more inhospital complications than at a one-star rated hospital and a 41 percent lower chance than at a three-star rated hospital during 2004- 2006.
* Five-star (top rated) hospitals performed almost twice the volume of procedures compared to 1-star and 3-star facilities-an average of 526 procedures from 2004 through 2006 compared with 266 and 283 respectively.
* Higher volume was associated with fewer risk-adjusted complications. Facilities with an annual case volume of 125 procedures had the lowest risk-adjusted complications. Facilities performing less than 25 cases per year had the highest rate of risk-adjusted complications.
* If all patients had received their bariatric surgery procedure at 5-star hospitals (from 2004 through 2006), 5,125 inhospital complications could have been potentially avoided in the 17 states studied.
HealthGrades Bariatric Surgery Ratings
HealthGrades' quality ratings for bariatric surgery at individual hospitals in 17 states were posted today to www.healthgrades.com as a free resource for consumers. Each hospital receives a star rating based on their patient outcomes for bariatric surgery. Hospitals with above-average outcomes receive a five-star rating. Hospitals with average outcomes receive a three-star rating, and hospitals with outcomes that are below average receive a one-star rating.
The study included a total of 154,451 bariatric inpatient surgery procedures performed in 680 hospitals in 17 states from 2004 through 2006. The majority of procedures were performed in four states: New York, Texas, Pennsylvania, and California.
* 93 hospitals stand out as "best" performers (5-star rated)
* 263 hospitals were rated as "as expected" performers (3-star rated)
* 99 hospitals were rated as "poor" performers (1-star rated)
Individuals contemplating bariatric surgery will find both quality and cost information at www.healthgrades.com. In addition to the free hospital-quality ratings, Web site visitors can also research surgeons who perform bariatric surgery as well as medical-cost reports that detail all of the costs, including out-of-pocket expenses, for the procedure.
Methodology
For this study, HealthGrades analyzed 154,451 bariatric procedures performed in the years 2004, 2005 and 2006. The states included in the study are: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, Texas, Utah, Virginia, Washington, Wisconsin
To make accurate and valid comparisons of clinical outcomes at different hospitals with different patient characteristics, HealthGrades risk adjusted the data using multivariate logistic regression to account for age, gender and underlying medical conditions that could increase the patient's risk of mortality or complication. The full study and individual hospital ratings for bariatric surgery and other procedures can be found at www.healthgrades.com.
HealthGrades
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