A recent study suggests that limiting who can perform weight loss surgeries may be making the procedures safer.
In 2001, there were over 70,000 weight loss surgeries performed in the U.S. The 30-day mortality rate was nearly 2%, which experts considered to be “relatively high.”
In 2006, the Centers for Medicare and Medicaid Services issued a national coverage determination (NCD) for weight loss surgeries that limited Medicare coverage to weight loss procedures performed at institutions certified by either the American College of Surgeons or the American Society for Metabolic and Bariatric Surgery. In order to be certified, hospitals would need to perform at least 125 procedures a year, show they had adequate staff and equipment, and have a system in place for following up on patients’ progress after bariatric surgery.
After the new NCD, the number of centers performing weight loss surgeries dropped from 60 to 45, but the total number of procedures performed remained about the same.
Researchers at the University of California Irvine Medical Center reviewed 3,196 operations performed on Medicare and Medicaid recipients in the 18 months before the NCD and 3,068 done in the 18 months afterward. Their findings indicated that limiting weight loss surgeries to “high volume centers” resulted in better outcomes for patients. The move to high volume centers led to shorter hospital stays, lower complication rates, and lower mortality rates.
Today, thanks in part to technological innovations and changes in regulations, weight loss surgeries now carry about the same risk for complication as gallbladder surgeries.