Every year, new ratings are released that rank the nation’s best (and worst) hospitals and other medical institutions. But for men and women considering bariatric surgery, there may be a real incentive to take a look at one specific study.

HealthGrades, the nations’ leading independent healthcare ratings organization, recently released its third annual Bariatric Surgery Trends in American Hospitals study. This lists the quality ratings of hospitals performing bariatric surgery, in terms of surgical outcomes. Surgical complication rates were shown to have increased 6% from 2004 to 2006. This may be due to the fact that lower-volume facilities have higher complication rates.

HealthGrades’ Finding Revealed

The study found that for bariatric procedures performed at top-rated facilities, patients typically had a 65% lower chance of experiencing serious complications compared to those undergoing procedures at poorly rated facilities. Generally, the study showed a significant shift toward laparoscopic bariatric procedures. Between 2004 and 2006,  open gastric bypass procedures declined by 81.82%,  while laparoscopic procedures increased 418.86%.

“The tremendous variation we are seeing in quality among bariatric surgery providers underscores the importance of readily available quality data to help consumers make a truly informed decision about where to seek care,” said Rick May, MD, a senior physician advisor with HealthGrades, as well as one of the study’s author. Here are a few other findings from the study:

• 93 hospitals were rated as “best” performers (5-star rated)
• 263 hospitals were rated as “as expected” performers (3-star rated)
• 99 hospitals were rated as “poor” performers (1-star rated)
• Typical patients undergoing bariatric surgical procedures at five-star rated hospitals in one of the 17 states experienced about a 65% lower chance of experiencing one or more in-hospital complications than at a one-star rated hospital. For the same time period, there was a 41% lower chance than at a three-star rated hospital.
• Five-star (top-rated) hospitals performed almost twice the volume of procedures compared to 1-star and 3-star facilities. Specifically, there was an average of 526 procedures performed between 2004-2006 compared with 266 and 283 respectively.
• There was a link between higher volume and fewer risk-adjusted complications. Those facilities with an annual case volume of 125 procedures had the lowest risk-adjusted complications. Meanwhile, facilities performing less than 25 cases annually had the highest rate of risk-adjusted complications.
• If all patients underwent their bariatric surgery procedures at 5-star hospitals during this time period, this would have potentially avoided 5,125 in-hospital complications in the 17 states studied.

Exploring the Popularity of Bariatric Surgery

In the United States, the number of bariatric surgical procedures is quickly growing. The American Society for Bariatric Surgery estimates that more than 250,000 are performed annually, an increase of 1,431% over the last decade!

For the study, HealthGrades analyzed more common surgical outcomes, such as the traditional open surgical gastric bypass procedures. However, the study also analyzed newer, less invasive procedures, including “lap-banding” and laparoscopic gastric bypass. Gastric bypass procedures’ complications accounted for a 17% rise (the highest), while less-invasive laparoscopic procedures’ complications increased by little more than 1%. Typical bariatric surgery complications include: heart attack, kidney failure, stroke and post-surgical infections.

Specifically, these rankings incorporated the findings of total of 154,451 bariatric inpatient surgery procedures performed in 680 hospitals between 2004 and 2006. The procedures were  performed in 17 states: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, Texas, Utah, Virginia, Washington, and Wisconsin. However, the majority of the procedures were performed in four states: New York, Texas, Pennsylvania, and California. The study’s full results are now available online at www.healthgrades.com.