Health Disparity in Access to Bariatric Surgery

Abstract Background Sociodemographic disparities in terms of access to bariatric surgery are ongoing. Objectives This study aimed to examine the trends for bariatric interventions based on patient characteristics from 2011 to 2018 in the State of New York. Setting Administrative statewide database. Methods This study used the New York Statewide Planning and Research Cooperative System database to identify all patients with obesity who underwent Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Sleeve Gastrectomy (SG) and Laparoscopic Adjustable Gastric Banding (LAGB) between 2011 and 2018. The trends for the types of bariatric procedures performed across different patient characteristics including median household income determined based on ZIP code, were studied. Multivariable logistic regression analysis was performed to compare the yearly trends. Results We identified 111,793 patients who underwent bariatric surgery. The number of bariatric procedures increased from 9,304 in 2011 to 16,946 in 2018. RYGB was the most performed bariatric operation in 2011, but was replaced by SG from 2013 to 2018. Patients living in the highest decile median household income ZIP code areas had the highest increase in SG (Odds ratio 1.51; 95% CI, 1.46-1.55; p Conclusions The use of bariatric surgery increased significantly from 2011 to 2018. However, disproportionate and substantial increased use of SG and decreased use of LAGB in patients living in wealthier areas suggest that disparity in the use of bariatric interventions still exists. Public health efforts should be made to equalize the access to bariatric surgery.