Date of Conferral

2017

Degree

Doctor of Healthcare Administration, DHA

School

Health Services

Advisor

James Rohrer

Abstract

Bariatric surgery is an effective procedure type for morbidly obese patients when all else fails. Because obesity is a chronic disease, prolonged assessment and understanding of the credibility of procedure types and their effects on bariatric surgery outcomes are essential, yet current evidence shows decreasing utilization of one of the dominant procedure types. To better compare outcomes of procedure type, this research was designed to control for volume, hospital size, age, gender, season, month, year, and ethnicity. The goal of the study was to compare the outcomes of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) bariatric surgery using the epidemiologic triad model. This study was a retrospective cross-sectional review of Nationwide Inpatient Sample (NIS) from 2009 to 2014. Univariate and multivariate logistic regression were conducted to analyze the data. This study was based on a secondary analysis previously collected from NIS data. A convenience sample of 73,086 patients who underwent bariatric surgery using ICD-9 diagnosis and procedure codes was used. Multiple logistic regression analysis indicated that LAGB (odds ratio [OR] =.043) and LSG (OR =.030) were positively associated with in-hospital mortality. Similarly, LAGB (OR =.041) and LSG (OR =.425) were positively correlated to length of stay (LOS). Finally, LAGB (OR = .461) and LSG (OR = .480) was positively related to reoperation. LAGB, when compared to LSG for LOS, had a substantial advantage over biliopancreatic diversion. The LOS findings may contribute to patients' value proposition, including cost reduction for third party insurance payers and for the community.

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