Association of socioeconomic disparities by payor status and perioperative outcomes in bariatric surgery.

BACKGROUND

Health care access is influenced by geographic, socioeconomic, and systemic factors. For patients undergoing metabolic and bariatric surgery (MBS), travel distance may reflect disparities in service availability, insurance limitations, and referral patterns to specialized centers.

OBJECTIVE

To test for an association between travel distance and 30-day postoperative outcomes, focusing on potential geographic biases to determine if patients who travel further face greater postoperative complications.

SETTING

Three Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project centers (2020-2023).

METHODS

Retrospective data from 1461 patients were analyzed. Travel distance from operative hospital was calculated using geocoding Area Deprivation Index (API) and Spearman's rank correlation assessed its relationship with outcomes including prolonged length of stay (LOS), infectious and serious complications, major adverse cardiac events (MACE), mortality, emergency department (ED) visits, and 30-day readmissions and reoperations.

RESULTS

No significant correlations were identified between travel distance and prolonged LOS > 5 days (P = .578), infectious complications (P = .703), serious complications (P = .190), MACE events (P = .159), or mortality (P = .073). Similarly, there was no significant association with the number of 30-day readmissions (P = .635) or reoperations (P = .094). However, a significant negative correlation between travel distance and emergency department visits (P < .0001) was observed.

CONCLUSION

While travel distance does not significantly impact postoperative complications or mortality, it may create logistical barriers that complicate follow-up care. Further research is needed to understand how travel-related challenges influence the management of postoperative complications.