Predictors of Attrition in Hispanics/Latinos Referred for Bariatric Surgery: Tailored Strategies Are Needed to Reduce Disparities

Factors associated with progression or non‐progression to bariatric surgery in adults: A systematic review

“…34,42,78 3.7 | Socio-economic status A total of 24 studies examined at least one measure of socio-economic status, with consistent trends across studies. Socioeconomic indicators like receiving disability payments, 32,79 lowincome, 69,75 accepting supplemental nutritional assistance packages, 28 holding immigration status, living in a poorer neighborhood, 32,38 and unemployment 32,38,60,79 were associated with greater chances of non-progression to surgery, which is consistent with the previous review. 21 The relationship between unemployment and higher odds of non-progression only applied to European patients in Taylor et al's 76 study.…”

“…Not including the review, 15/16 of these studies were based in the United States, and the remaining study was conducted in Australia. Holding private insurance predicted progression to surgery, 37,49,52 while having public insurance was associated with non‐progression in samples of African–American and Hispanic patients 69,70 . In addition, participants were deterred from surgery because of insurance denial and complications, 42,54,66 with Xie et al 77 further identifying that more surgery non‐completers, relative to completers, were uninsured.…”

“…In terms of orientation session format, Shapiro et al 71 and Parnell et al 61 found no effect, but Miletics et al 55 identified a higher non‐progression rate among online attendees (compared with in‐person attendees), while Monfared et al 57 discovered the opposite to be true. Furthermore, telehealth appointments (versus in‐person consultations) were associated with surgical completion among samples of African–American and Hispanic patients 69,70 …”

“…Holding private insurance predicted progression to surgery, 37,49,52 while having public insurance was associated with non-progression in samples of African-American and Hispanic patients. 69,70 In addition, participants were deterred from surgery because of insurance denial and complications, 42,54,66 with Xie et al 77 further identifying that more surgery non-completers, relative to completers, were uninsured. Around 50% of the participants in Hlavin et al's38 study also "somewhat" or "strongly agreed" that the insurance process takes too long.…”

“…Furthermore, telehealth appointments (versus in-person consultations) were associated with surgical completion among samples of African-American and Hispanic patients. 69,70 Insurance and program requirements, such as providing a primary physician letter, advanced laboratory testing, urine drug screening, medical evaluations (cardiology, respiratory, endocrinology, and hematology), additional psychological evaluation, longer dieting time, medically supervised weight loss documentation, and extra dietitian sessions predicted greater odds of non-progression to surgery. 24,49 Two additional studies identified a relationship between dietary consultations and discontinuation, while a decreased number of surgeon visits was associated with non-progression to surgery.…”