Insurance-Related Delay in Access to Bariatric Surgery, Is It Helpful as Is Thought?
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ORIGINAL CONTRIBUTIONS
Insurance-Related Delay in Access to Bariatric Surgery, Is It Helpful as Is Thought? Emiliano Domeniconi 1 & Carlos Martin Esquivel 2,3 & Manuel Garcia 2,3 & Matias Sosa 4 & Pablo Arias 5 & Fernando Martínez Lascano 2,3,6 & José María Foscarini 2,6
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background In Argentina, health insurances demand a 24-month duration preoperative weight loss program (POWLP) before bariatric surgery. It is unknown whether it enhances weight loss before or after surgery, or even if it is related to comorbidity remission. The main objective of this study was to determine its effectiveness and reliability. Methods An observational, longitudinal, retrospective study was carried out from June 2009 to December 2016, enrolling patients who underwent bariatric surgery in Sanatorio Allende Hospital of Cordoba, Argentina. Patients were divided into three groups according time-to-surgery from preoperative assessment initiation (A = before the 6th month, B = from 6th to 24th month, and C = over 24th month; all related to the first visit as previously mentioned). BMI, %EWL, comorbidity remission BMI, %EWL, comorbidity remission, and complications rate were assessed after surgery at 1, 3, 6, 12 months, and then annually until the 5th postoperative year. Revisional surgeries were excluded. Results Three hundred seventy-six patients were recruited. There were no significant differences in the preoperative and postoperative weight loss, neither co-morbidities resolution between groups. Conclusions Insurance-related delay in access to bariatric surgery is not associated to any benefit in comorbidity remission, as well as any improvement in weight loss in all groups studied. Keywords Bariatric surgery . Laparoscopic Roux-en-Y gastric bypass . Laparoscopic sleeve . Gastrectomy . Preoperative weight loss program . Weight loss
Introduction Obesity is a worldwide health issue, with an uprising prevalence in developed as well as undeveloped countries. It is a
* Carlos Martin Esquivel [email protected]
chronic, progressive, and multifactorial disease that affects quality of life, and reduces life expectancy due to several harmful effects due to numerous related conditions such as type 2 diabetes, cardiovascular disease, hypertension,
1
General and Bariatric Surgeon - Regional Hospital of Rios Gallegos, 98 José Ingenieros St., 9400 Río Gallegos, Santa Cruz, Argentina
2
General and Bariatric Surgeon, Sanatorio Allende of Córdoba, 5749 Pedro Simon Laplace st, 5000 Villa Belgrano, Córdoba, Argentina
3
Catholic University of Córdoba, 3555 Armada Argentina Avenue, 5000 Córdoba, Córdoba, Argentina
4
General and Bariatric Surgeon, Clínica Modelo of Paraná - Entre ríos, 1238 Gral. José de San Martín St., 3100 Paraná, Entre Ríos, Argentina
Fernando Martínez Lascano [email protected]
5
General and Bariatric Surgeon, Clínica San Rafael, 566 Sarmiento Avenue, 4400 Salta, Salta, Argentina
José María Foscarini [email protected]
6
Uni
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