Valukas Catherine S, Sanchez Joseph, Vitello Dominic, Hungness Eric P, Teitelbaum Ezra N, Feinglass Joe
Northwestern Quality Improvement, Research and Education in Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
Northwestern Quality Improvement, Research and Education in Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
Surg Obes Relat Dis. 2025 Jun;21(6):682-688. doi: 10.1016/j.soard.2024.11.022. Epub 2024 Dec 7.
Utilization of metabolic and bariatric surgery has increased significantly over the last 2decades, yet barriers to access remain.
This study aimed to 1) define rates of metabolic and bariatric surgery utilization for qualifying adults in Illinois and 2) describe patient characteristics associated with undergoing surgery at Illinois hospitals with low metabolic and bariatric surgery volume.
Metabolic and bariatric surgery at all nonfederal Illinois hospitals was included.
Illinois hospital administrative data for 2016-2022 metabolic and bariatric surgery procedures (numerators) and Illinois Behavioral Risk Factor Surveillance System population estimates (denominators) were used to compute metabolic and bariatric surgery rates per estimated 100,000 Illinois residents ages 18-69 who qualified for metabolic and bariatric surgery based on National Institutes of Health Guidelines. Zip code median income was obtained from census data. Multivariable logistic regression was used to identify patient characteristics associated with receiving metabolic and bariatric surgery at low volume hospitals (LVHs), defined as less than 50 annual bariatric procedures.
The average annual metabolic and bariatric surgery rate was 702 per 100,000 qualifying Illinois adults. Rates were highest among non-Hispanic Black patients (890/100,000) and lowest for Hispanic patients (396/100,000) and patients from zip codes with median household income <$75,000. Lower median household income was the only characteristic associated with use of LVHs.
Metabolic and bariatric surgery procedures almost doubled over the study period in Illinois, increasing the most for non-Hispanic Black and Medicaid patients. However, Hispanic and low-income patients still have rates well below the state average.
在过去20年里，代谢与减重手术的应用显著增加，但仍存在获取手术的障碍。
本研究旨在1）确定伊利诺伊州符合条件的成年人进行代谢与减重手术的使用率，以及2）描述在伊利诺伊州代谢与减重手术量较低的医院接受手术的患者特征。
纳入伊利诺伊州所有非联邦医院的代谢与减重手术。
利用伊利诺伊州医院2016 - 2022年代谢与减重手术程序的行政数据（分子）和伊利诺伊州行为风险因素监测系统的人口估计数（分母），计算每10万名年龄在18 - 69岁、根据美国国立卫生研究院指南符合代谢与减重手术条件的伊利诺伊州居民的代谢与减重手术率。邮政编码区域的收入中位数来自人口普查数据。采用多变量逻辑回归来确定与在低手术量医院（LVH）接受代谢与减重手术相关的患者特征，低手术量医院定义为每年减重手术程序少于50例。
伊利诺伊州符合条件的成年人均每年代谢与减重手术率为每10万人702例。非西班牙裔黑人患者的手术率最高（890/10万），西班牙裔患者（396/10万）和来自家庭收入中位数低于75,000美元邮政编码区域的患者手术率最低。家庭收入中位数较低是与使用低手术量医院相关的唯一特征。
在研究期间，伊利诺伊州的代谢与减重手术程序几乎翻了一番，非西班牙裔黑人和医疗补助患者的增幅最大。然而，西班牙裔和低收入患者的手术率仍远低于该州平均水平。
