Evidence map›Paper›PMID 30425002›Full record

ReviewSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery2019

Reasons for underutilization of bariatric surgery: The role of insurance benefit design.

Hamlet Gasoyan, Gabriel Tajeu, Michael T Halpern, David B Sarwer

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 2 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 2 syntheses or guidelines pooled it, 154 citations in OpenAlex.

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27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Hamlet GasoyanDepartment of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania. Electronic address: hamlet.gasoyan@temple.edu.
Gabriel TajeuDepartment of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania.
Michael T HalpernDepartment of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania.
David B SarwerCenter for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania.
Temple University · USTemple College · US

Funding

Psychopathology, Disordered Eating, and Impulsivity as Predictors of Outcomes of Bariatric SurgeryR01DK108628 · NIDDK · TEMPLE UNIV OF THE COMMONWEALTH · PI SARWER, DAVID B · 2015 to 2019
$2.1M
NIDDK NIH HHS R01 DK108628
6 · The paper itself

Abstract

Despite the effectiveness of bariatric surgery, both with respect to weight loss and improvements in obesity-related co-morbidities, it remains underused. Only 1% of the currently eligible population undergoes surgical treatment for obesity, with roughly 228,000 individuals receiving bariatric surgery in the United States each year. Several barriers to bariatric surgery have been identified, including limited patient and referring physician knowledge and attitudes regarding the effectiveness and safety of bariatric surgery. However, the role of insurance coverage and benefit design as a barrier to access to care has received less attention to date. Bariatric surgery is cost-effective compared with nonsurgical treatments among individuals with extreme obesity and type 2 diabetes. While it may not result in cost savings among all bariatric surgery eligible patients, for certain patient subgroups, bariatric surgery may be cost neutral compared with traditional treatment options. In addition, longer-term outcomes of bariatric surgery suggest decreased or stable costs in the long run. The purpose of this review paper was to synthesize the existing knowledge on why bariatric surgery remains largely underused in the United States with a focus on health insurance benefits and design. In addition, the review discusses the applicability of value-based insurance design to bariatric surgery. Value-based insurance design has been previously applied to bariatric surgery coverage with use of incentive-based cost-sharing adjustments. Its application could be further extended because the postoperative clinical outcomes and costs vary among the different subgroups of bariatric surgery eligible patients.

Indexed as

Bariatric SurgeryInsurance BenefitsObesity, MorbidHealth Services AccessibilityHumansAccess to careBariatric surgeryBarriersUtilizationValue-based insurance design

Identifiers

PMID30425002
PMCPMC6441615
OpenAlexW2897370925

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.