Impact of Obesity on Resource Utilization for General Surgical Procedures

Hawn, Mary T.; Bian, John; Leeth, Ruth R.; Ritchie, Gilbert; Allen, Nechol L.; Bland, Kirby I.; Vickers, Selwyn M.

doi:10.1097/01.sla.0000161044.20857.24

Cited by 115 publications

(89 citation statements)

References 24 publications

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“…Obesity exerts major burdens on health care in many ways, from obviously obesity-related conditions (14)(15)(16) to the hidden costs of personal care and indirect costs associated with absenteeism, disability, premature mortality and workers' compensation (17). The health care costs of obesity extend well beyond the conventional costs of obesity-related diseases, with increased prescribing costs in almost all drug classes (18).…”

Section: Introductionmentioning

confidence: 99%

Impaired quality of life and sexual function in overweight and obese men: the European Male Ageing Study

Han¹,

Tajar²,

O’Neill³

et al. 2011

European Journal of Endocrinology

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Background: Few published data link overweight and obesity with measures of quality of life (QoL) including sexual health in men. Objective: To assess the association of overweight/obesity with impairment of physical and psychological QoL and sexual functions in men. Design and setting: Cross-sectional, multicentre survey of 3369 community-dwelling men aged 40-79 (meanGS.D., 60G11) years randomly selected from eight European centres. Outcomes: Adiposity was assessed by body mass index (BMI) and waist circumference (WC), QoL and functional impairments by physical and psychological function domains of the Short Form-36 questionnaire, Beck's Depression Inventory and the European Male Ageing Study sexual function questionnaire. Results: Complete data on sexual activities and erectile function were available in 2734 (92%) and 3193 (95%) of the participants respectively. From the population studied, 814 men were obese (BMI R30 kg/m

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Section: Introductionmentioning

confidence: 99%

Impaired quality of life and sexual function in overweight and obese men: the European Male Ageing Study

Han¹,

Tajar²,

O’Neill³

et al. 2011

European Journal of Endocrinology

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“…Studies have documented that operating on obese patients leads to longer and more difficult operations with greater complications [6][7][8]. Furthermore, the requirement to report outcomes and the push to contain costs may lead to shying away from operating on patients who are perceived as having the potential for worse outcomes and increased costs of care.…”

Section: Introductionmentioning

confidence: 99%

Costs and Outcomes of Privately-Insured Kidney Transplant Recipients by Body Mass Index

Ercole

Buchanan

Lentine

et al. 2012

J Nephrol Therapeutic

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“…1 Performing surgical procedures on obese patients is more difficult, takes longer, and is subject to a higher rate of complications. [2][3][4][5][6][7] Current billing practices and mandates for reporting of surgeon outcomes are disincentives to operating on patients with predictably longer hospital stays and more complications. 8 -15 It has been hypothesized that worse outcomes and financial disincentives might be contributing to a system-wide bias against surgical care for obese patients, even in situations in which surgical therapy might provide for the best outcome.…”

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confidence: 99%

Obesity Impacts Access to Kidney Transplantation

Segev

Simpkins

Thompson

et al. 2008

Journal of the American Society of Nephrology

226

163

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Current billing practices and mandates to report surgical outcomes are disincentives to surgical treatment of obese patients, who are at increased risk for longer hospital stays and higher complication rates. The objective of this study was to quantify the independent association between body mass index (BMI) and waiting time for kidney transplantation to identify potential provider bias against surgical treatment of the obese. A secondary data analysis was performed of a prospective cohort of 132,353 patients who were registered for kidney transplantation in the United States between 1995 and 2006. Among all patients awaiting kidney transplantation, the likelihood of receiving a transplant decreased with increasing degree of obesity, categorized by ranges of BMI (adjusted hazard ratios 0.96 for overweight, 0.93 for obese, 0.72 for severely obese, and 0.56 for morbidly obese, compared with a reference group of patients with normal BMI). Similarly, the likelihood of being bypassed when an organ became available increased in a graded manner with category of obesity (adjusted incidence rate ratio 1.02 for overweight, 1.05 for obese, 1.11 for severely obese, and 1.22 for morbidly obese). Although matching an available organ with an appropriate recipient requires clinical judgment, which could not be fully captured in this study, the observed differences are dramatic and warrant further studies to understand this effect better and to design a system that is less susceptible to unintended bias.

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Impact of Obesity on Resource Utilization for General Surgical Procedures

Abstract: Obesity significantly increased OT for each procedure studied. These data have implications for health policy and surgical resource utilization. We suggest that a CPT modifier to appropriately reimburse surgeons caring for obese patients be considered.

Cited by 115 publications

References 24 publications

Impaired quality of life and sexual function in overweight and obese men: the European Male Ageing Study

Impaired quality of life and sexual function in overweight and obese men: the European Male Ageing Study

Costs and Outcomes of Privately-Insured Kidney Transplant Recipients by Body Mass Index

Obesity Impacts Access to Kidney Transplantation

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