Distressed community index as a predictor of metabolic and bariatric surgery outcomes.

Abstract

Background: Obesity is associated with serious health and social consequences. Socioeconomically disadvantaged people are less likely to undergo metabolic and bariatric surgery (MBS) than their socioeconomically advantaged counterparts and experience increased complications or health care resource utilization, such as longer length of stay. The Economic Innovation Group's Distressed Communities Index (DCI) offers a metric to broadly assess socioeconomic distress.

Objectives: This study investigated the relationship between community distress, as determined by DCI, and complications following MBS, including length of hospital stay, likelihood of an emergency department (ED) visit, 30-day readmissions, and perioperative/postoperative occurrences.

Setting: Academic Medical Center, United States.

Methods: We conducted a retrospective analysis on a cohort of patients undergoing primary sleeve gastrectomy or Roux-en-Y bypass at a large academic hospital from 2016 to 2020 (n = 758). Patients were categorized based on the DCI of their community. We used the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database to record each patient's postoperative complications. Descriptive statistics were used to evaluate the association between community distress and complications.

Results: Patients from distressed communities were more likely to have Medicaid and less likely to have private insurance (P < .001). Community distress was significantly correlated with longer hospital stay (P < .001) and a higher likelihood of an ED visit (P < .007). No significant correlation was observed between community distress and 30-day readmissions or perioperative/postoperative occurrences.

Conclusions: DCI is not an independent risk factor for complications after adjusting for other variables but increase resource utilization.