Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Am J Gastroenterol. 2013 Aug;108(8):1218-23. doi: 10.1038/ajg.2012.365.
We examined national trends in bariatric surgery for adults, focusing on differences in utilization by race and access to health care.
We analyzed subjects eligible for bariatric surgery in the National Hospital Discharge Survey and the National Health and Nutrition Examination Survey for 1999-2010. Primary outcome measures included population-based estimates and comparison of blacks and whites eligible for surgery with those who actually received it.
A higher percentage of black than white women and of black than white men were eligible for bariatric surgery. But a higher proportion of eligible white women and men than black women and men received bariatric surgery. 69.8% of eligible white women and 72.9% of white women who received bariatric surgery had private health insurance, compared with 49.9% and 71.1% of black women. 71.4% of eligible white men and 75.9% of white men who received bariatric surgery had private health insurance, compared with 52.4% and 74.7% of black men. Among men eligibility and surgery rates were lower than for women of the same race, and significant differences were found by race in the same directions as for women.
Eligible whites received bariatric surgery at higher levels than eligible blacks, apparently partly because of differences in insurance coverage.
我们研究了美国成年人接受减重手术的全国性趋势,重点关注不同种族之间利用手术的差异以及获得医疗保健的机会。
我们分析了 1999 年至 2010 年国家医院出院调查和国家健康与营养调查中适合接受减重手术的人群。主要评估指标包括人口统计学估计和比较有资格接受手术的黑人和白人患者与实际接受手术的患者之间的差异。
与白人女性相比,更多的黑人女性和黑人男性有资格接受减重手术;但与黑人女性和男性相比,更多的白人女性和男性有资格接受减重手术。69.8%的白人女性和 72.9%的接受减重手术的白人女性拥有私人医疗保险,而黑人女性的这一比例为 49.9%和 71.1%。71.4%的白人男性和 75.9%的接受减重手术的白人男性拥有私人医疗保险,而黑人男性的这一比例为 52.4%和 74.7%。在男性中,与同种族的女性相比,接受减重手术的比例较低,而且不同种族之间的差异与女性相似。
与有资格的黑人相比,有资格的白人接受减重手术的比例更高,这显然部分归因于保险覆盖范围的差异。