Evidence map›Paper›PMID 35513536›Full record

ArticleSurgical endoscopy2022

Variation in pre-operative insurance requirements for bariatric surgery.

Amalia E Gomez-Rexrode, Karan R Chhabra, Dana A Telem, Grace F Chao

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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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

4 authors at 2 institutions in 1 country.

Amalia E Gomez-RexrodeUniversity of Michigan Medical School, Ann Arbor, MI, USA.
Karan R ChhabraDepartment of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Dana A TelemInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
Grace F ChaoInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. grace.f.chao@yale.edu.ORCID http://orcid.org/0000-0003-3133-9827
University of Michigan · USBrigham and Women's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor patients who wish to undergo bariatric surgery, variation in pre-operative insurance requirements may represent inequity across insurance plan types. We conducted a cross-sectional assessment of the variation in pre-operative insurance requirements.

methodsOriginal insurance policy documents for pre-operative requirements were obtained from bariatric surgery programs across the entire USA and online insurance portals. Insurance programs analyzed include commercial, Medicaid, and Medicare/TriCare plans. Poisson regression adjusting for U.S. Census region was used to evaluate variation in pre-operative requirements. Analyses were done at the insurance plan level. Our primary outcome was number of requirements required by each plan by insurance type. Our secondary outcome was number of months required to participate in medically supervised weight loss (MSWL).

resultsAmong 43 insurance plans reviewed, representing commercial (60.5%), Medicaid (25.6%), and Medicare/TriCare (14.0%) plans, the number of pre-operative requirements ranged from 1 to 8. Adjusted Poisson regression showed significant variation in pre-operative requirements across plan types with Medicaid-insured patients required to fulfill the greatest number (4.1, 95%CI 2.7 to 5.4) compared to 2.7 (95%CI 2.2 to 3.2, P = 0.028) for commercially insured patients and 2.1 (95%CI 1.1 to 3.1, P = 0.047) for Medicare/TriCare-insured patients. Medicaid-insured patients were also required to complete a greater number of months in MSWL (6.6, 95%CI 5.5 to 7.6) compared to commercially (3.8, 95%CI 2.9 to 4.8, P < .001) and Medicare/TriCare-insured patients (1.7, 95%CI 0.3 to 3.0, P = .001).

conclusionThe greater frequency of pre-operative requirements in Medicaid plans compared to Medicare/TriCare and commercial plans demonstrates inequity across insurance types which may negatively impact access to bariatric surgery. Pre-operative insurance requirements must be reevaluated and standardized using established evidence to ensure all individuals have access to this life-saving intervention.

Indexed as

Bariatric SurgeryMedicareAgedCross-Sectional StudiesHumansInsurance CoverageInsurance, HealthMedicaidUnited StatesWeight LossBariatric surgeryInsurance coveragePre-operative requirements

Identifiers

PMID35513536
OpenAlexW4229035828

What OpenQuestion holds

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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.