Disparities in Access to Bariatric Surgery in Texas 2013–2017

Abstract

Background: Access to bariatric care varies across regions, ethnic, and racial groups. Some of these variations may be due to insurance status or socioeconomic status. There are also regional and state variations in access to metabolic and bariatric surgery (MBS). The Texas Inpatient Public Use Data File (IPUDF) and Texas Outpatient Public Use Data File is a state-mandated database that collects information on demographics, procedures, diagnoses, and cost on almost all admissions in Texas. We used them to examine racial disparities in MBS over a 5-y period. Methods: The IPUDF and Texas Outpatient Public Use Data File were examined from the years 2013 through, 2017. We included all patients undergoing a laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy and examined the demographics of these patients. Race and ethnicity are reported separately. We used U.S. Census Bureau statistics and the Texas Department of State Health Services statistics to determine the crude (unadjusted) and adjusted procedure rates of patients undergoing MBS. Results: In the IUPUDF, the crude unadjusted procedure rate for blacks undergoing MBS was 7.29 per 10,000 population followed by 6.85 per 10,000 for non-Hispanic whites. Hispanics had the lowest rate at 3.20 per 10,000. When adjusted for sex, obesity, age, and race, blacks still had a higher rate of access followed by whites and then Hispanics. Conclusions: There are disparities to access for bariatric surgery in Texas. Blacks have the greatest access followed by whites. Hispanics have the lowest procedure rate per population.

The Impact of Racial Disparities on Liver Disease Access and Outcomes

“…However, there is evidence of racial disparities to access to roux en Y gastric bypass and sleeve gastrectomy for Hispanic patients. Using the Texas Inpatient and Outpatient Public Use Data Files, from 2013 to 2017 the unadjusted procedure rate was 7.29 per 100,000 for Black patients, 6.85 per 10,000 for non-Hispanic White patients, and 3.20 per 10,000 for Hispanic patients [51]. In 2015, after adjusting for sex, race, age, and obesity, Black women had the highest surgery rate at 6.37% and Hispanic women at the lowest surgery rate at 0.25%.…”

Investigating discrepancies in demand and access for bariatric surgery across different demographics in the COVID-19 era

“…Factors contributing to obesity in certain races include genetics, diet, physical activity, psychological stress, income, and discrimination [ [25] , [26] , [27] ]. Similarly, Latinos/Hispanics have a low rate of bariatric surgery which is attributed to inequality in access to care and financial coverage, low referral rates by primary care physicians, and societal values about obesity combined with distrust of the healthcare system [ 28 , 29 ].…”

Characteristics and resolution of hypertension in obese African American bariatric cohort

“…Prevalence of HTN is highest and its resolution lowest among African Americans (AA) undergoing BS compared to other racial and ethnic groups 42 – 44 . Income brackets and bariatric surgery access 45 as well as outcomes including weight-loss and comorbidity resolution 46 , 47 in states such as Michigan and Texas, for example, differ between blacks and whites where blacks have higher rate of 30-day complications and lower weight loss at 1 year following Roux-en-Y gastric bypass (RYGB) surgery. Among comorbidities, the Gateway Randomized Trial noted that recent research efforts on BS heavily focused on metabolic and DM resolution, but not on hypertension 39 .…”