Post-bariatric contour deformity correction: an endeavour to establish objective criteria nationally.

Brühlmann, Jérémy; Lese, Ioana; Grobbelaar, Adriaan O.; Fischlin, Claudia; Constantinescu, Mihai; Olariu, Radu (2022). Post-bariatric contour deformity correction: an endeavour to establish objective criteria nationally. Swiss medical weekly, 152(w30131), w30131. EMH Media 10.4414/smw.2022.w30131

[img]
Preview
Text
smw_152_w30131.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial-Share Alike (CC-BY-NC-SA).

Download (758kB) | Preview

BACKGROUND

A marked increase in bariatric surgery has led to higher numbers of patients with contour deformities after massive weight loss seeking plastic surgical correction. Insurance coverage for these post-bariatric interventions is highly subjective and a common set of objective criteria has not yet been established.

AIM

The aim was to evaluate the factors influencing insurance coverage for post-bariatric surgery, focusing on finding objective, reproducible criteria.

METHODS

This was a retrospective single centre chart review of all post-bariatric patients with redundant skin requesting body contouring surgery from 2013 to 2018. Demographic, bariatric and surgical, as well as insurance information were collected. A logistic regression model was used to identify predictors of successful insurance coverage.

RESULTS

116 Patients were included in the study. Insurance approval for post-bariatric body contouring surgery was obtained for only 47 patients (41%). Mentioning the term "medical indication" in the application letter was associated with a 15.2 times higher rate of receiving a positive answer (p <0.001), whereas mentioning "mental suffering" was associated with 82.3% lower chance of getting a positive response (p <0.001). A high body mass index (BMI) (p <0.009) before the bariatric operation as well as a high BMI reduction (p <0.021) were associated with a higher approval rate by insurance companies . An additional application letter to the insurance company (p <0.024) as well as mentioning mechanical restriction (p <0.022) were associated with a positive response from the insurance companies.

CONCLUSIONS

We were able to establish certain objective predictive criteria for insurance coverage of post-bariatric surgery. However, it appears that the decisions of insurance companies for this condition are still rather randomly taken. Therefore, the establishment of objective criteria for insurance coverage may allow fairer treatment for this growing patient population.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery

UniBE Contributor:

Brühlmann, Jérémy, Lese, Ioana, Grobbelaar, Adriaan Ockert, Fischlin, Claudia, Constantinescu, Mihai Adrian, Olariu, Radu

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-3997

Publisher:

EMH Media

Language:

English

Submitter:

Veronika Picha

Date Deposited:

31 Mar 2022 16:59

Last Modified:

05 Dec 2022 16:16

Publisher DOI:

10.4414/smw.2022.w30131

PubMed ID:

35315267

BORIS DOI:

10.48350/167935

URI:

https://boris.unibe.ch/id/eprint/167935

Actions (login required)

Edit item Edit item
Provide Feedback