Weight-Loss Surgery Results No Better at 'Best' Hospitals
For Medicare patients, having bariatric surgery at a designated "center of excellence" did not offer better outcomes, researchers found.
In a retrospective study, there were no differences in any complications between centers that had the designation and those that did not (RR 0.98, 95% CI 0.90 to 1.06), according to Justin Dimick, MD, MPH, of the University of Michigan in Ann Arbor, and colleagues.
"Combined with prior studies showing no association of [center of excellence] designation and outcomes, these results suggest that Medicare should reconsider this policy" of paying for bariatric surgery only when it's done at such a facility, they wrote in the Feb. 27 issue of the Journal of the American Medical Association.
In 2006, the Centers for Medicare and Medicaid Services (CMS) issued a national coverage decision that limited reimbursement of weight-loss surgery to centers of excellence that were accredited by either the American College of Surgeons or the American Society for Metabolic and Bariatric Surgery.
But some work has suggested that these centers may not have better outcomes than non-accredited institutions.
So Dimick and colleagues looked at hospital discharge data from 12 states between 2004 and 2009 on 6,723 Medicare patients who had surgery before the coverage decision and 15,854 who had it after.
They also assessed a non-Medicare population of 95,558 patients who had surgery before the decision and 155,117 who had it after.