Beyond insurance: race-based disparities in the use of metabolic and bariatric surgery for the management of severe pediatric obesity
Beyond insurance: race-based disparities in the use of metabolic and bariatric surgery for the management of severe pediatric obesity
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DOI：
10.1016/j.soard.2019.11.020
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发表时间：
2020-03-01
影响因子：
3.1
通讯作者：
Kelleher, Cassandra M.
中科院分区：
文献类型：
--
作者：
Perez, Numa P.;Westfal, Maggie L.;Kelleher, Cassandra M.
背景资料：目前尚不清楚是否先前注意到的种族差异，在使用代谢和减肥手术（MBS）的儿童肥胖的管理可以减轻会计的主要insurance.Objectives：检查利用儿科MBS跨种族和保险在美国。设置：回顾性横断面研究。方法：国家住院患者样本用于识别2015年至2016年接受MBS的12至19岁患者，这些数据与2015年至2016年全国健康和营养检查调查中获得的儿童肥胖的全国估计值相结合。重度肥胖定义为III类肥胖，或II类肥胖加上高血压，血脂异常，或2型diabetes.Results：共1,659,507（5.0%）的青少年严重肥胖的确定，包括35.0%的女性，38.0%的白色，和45.0%的私人投保的青少年。在同一时间段内，进行了2535例MBS手术。大多数手术患者为女性（77.5%）、白色（52.8%）和私人保险（57.5%）。与白人相比，黑人和西班牙裔青少年较少发生MBS（比值比分别为0.50，0.46; P
Background: It is unknown whether previously noted racial disparities in the use of metabolic and bariatric surgery (MBS) for the management of pediatric obesity could be mitigated by accounting for primary insurance.Objectives: To examine utilization of pediatric MBS across race and insurance in the United States.Setting: Retrospective cross-sectional study.Methods: The National Inpatient Sample was used to identify patients 12 to 19 years old undergoing MBS from 2015 to 2016, and these data were combined with national estimates of pediatric obesity obtained from the 2015 to 2016 National Health and Nutrition Examination Survey. Severe obesity was defined as class III obesity, or class II obesity plus hypertension, dyslipidemia, or type 2 diabetes.Results: A total of 1,659,507 (5.0%) adolescents with severe obesity were identified, consisting of 35.0% female, 38.0% white, and 45.0% privately insured adolescents. Over the same time period, 2535 MBS procedures were performed. Most surgical patients were female (77.5%), white (52.8%), and privately insured (57.5%). Black and Hispanic adolescents were less likely to undergo MBS than whites (odds ratio .50, .46, respectively; P