Evidence map›Paper›PMID 34687410›Full record

ArticleObesity surgery2022

Insurance Coverage of Pediatric Bariatric Surgery: a Cross-Sectional Analysis of the USA.

Brooks J Knighton, Cynthia T Yusuf, Michael Ha, Ledibabari M Ngaage, Selim Gebran, Natalia Kubicki, Mark D Kligman, Yvonne M Rasko

Abstract read
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In one paragraph

Article in Obesity surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Beyond surgery: a multimodal framework for a pediatric metabolic and bariatric surgery program in a safety-net children's hospital.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026
    Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Brooks J KnightonUniversity of Maryland School of Medicine, Baltimore, 21201, USA.
Cynthia T YusufUniversity of Maryland School of Medicine, Baltimore, 21201, USA.
Michael HaDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD, 21201, USA.
Ledibabari M NgaageDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD, 21201, USA.
Selim GebranDivision of Plastic Surgery, Department of Surgery, Johns Hopkins Medicine, Baltimore, 21205, USA.
Natalia KubickiDepartment of Surgery, University of Maryland Medical Center, Baltimore, 21201, USA.
Mark D KligmanDepartment of Surgery, University of Maryland Medical Center, Baltimore, 21201, USA.
Yvonne M RaskoDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD, 21201, USA. yrasko@som.umaryland.edu.ORCID http://orcid.org/0000-0003-0051-0273

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePediatric bariatric surgery is increasingly recognized as a safe and effective option for the management of obesity and obesity-related conditions. However, insurance coverage is a key barrier to accessing these procedures. Criteria are variable and often not evidence-based. In an effort to characterize common patterns in insurance coverage, we report coverage criteria for adolescents relative to adults. MATERIALS AND

methodsWe surveyed medical policies of the 50 highest market share health insurance providers in the USA. Private insurer coverage criteria included age, Tanner staging, skeletal maturity, body mass index, procedures covered, medical weight management requirements, co-morbidities, and multidisciplinary team criteria. These were then compared to the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines.

resultsTwo thirds (n = 33, 66%) of companies provided inclusion criteria for adolescents. All policies covered RYGB (n = 33), most covered sleeve gastrectomy (n = 32, 97.0%). Obstructive sleep apnea (OSA) (n = 32, 97%), hypertension (HTN) (n = 27, 81.8%), and gastroesophageal reflux disease (GERD) (n = 11, 33.3%) were the three most commonly cited co-morbidities used as inclusion criteria. Tanner staging or skeletal maturity were most commonly used (n = 10, 30.3%). Similarly, twenty (60.6%) insurers required medical weight management programs. Multi-disciplinary teams were required by 81.8% of adolescent policies (n = 27) as described by the ASMBS. Seventeen (51.5%) policies defined providers for these teams, and 10 (30.3%) provided other defined criteria.

conclusionContrary to ASMBS guidelines, companies commonly require Tanner staging and/or skeletal maturity criteria as well as participation in medical weight management programs. Also, multi-disciplinary team are frequently required but not well defined.

Indexed as

Bariatric SurgeryObesity, MorbidAdolescentAdultChildCross-Sectional StudiesHumansInsurance CoverageObesityBariatric surgeryInsuranceObesityPediatric surgeryWeight loss surgery

Identifiers

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Registered trials

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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.