Today's Date: May 8, 2021
IPG Mediabrands Shares Media Equity Commitment to Encourage Investment in Black-Owned Media   •   Publix Accepts Walk-in Customers for COVID‑19 Vaccinations in All Seven of Its States   •   AHF Issues $100M Homeless Challenge to Mayor Garcetti, L.A. City Council in New L.A. Times Ad   •   Hello Sunshine’s Fair Play Brand, Glamour and CVS To Host “Dare to Self-Care” Virtual Wellness Event on May 10   •   HCSS Hosts TWU Houston 2021 Graduation With Drive-Through Event   •   Women in Manufacturing Association Announces “Moms in MFG,” a New Event for Moms Working in the Manufacturing Sector   •   Supporting Local Communities: PG&E Contributes $200,000 to Celebrate and Support the Asian American Pacific Islander Communi   •   Short documentary Dear Georgina spotlighting life of Passamaquoddy elder streaming launch May 7   •   Sen. Jon Ossoff Announces that Clark Atlanta University Will Receive Approximately $16.4 Million from the American Rescue Plan   •   Minister Miller talks about mental wellness during the pandemic   •   Toyota Ranks 7th on DiversityInc's Top 50 Companies for Diversity   •   The Tech Convenes Top STEM Professionals to Advise Young Women on Career Paths   •   CGTN: How does Xi Jinping express gratitude and love to his mother?   •   United Way of King County Launches New Campaign to Address Growing Food Insecurity Due to Pandemic   •   Skypod Supports American Pregnancy Association   •   Six Flags Hurricane Harbor to Reopen May 15   •   UBS Declares Coupon Payments on 5 ETRACS Exchange Traded Notes   •   MedShare to Give Expectant Mothers in Underserved Bay Area Communities Access to State-of-the-Art Philips Ultrasound Imaging Sol   •   Graymoor Ecumenical and Interreligious Institute Shares Theme for 2022 Week of Prayer for Christian Unity   •   Waldencast Acquisition Corp. Announces the Separate Trading of Its Class A Ordinary Shares and Redeemable Warrants Commencing Ma
Bookmark and Share

New MD Plan Not Good For Obese Blacks


Pay-for-performance reimbursement of surgeons, intended to reward 
doctors and hospitals for good patient outcomes, may instead be 
creating financial incentives for discriminating against obese 
patients, who are much more likely to suffer expensive complications 
after even the most routine surgeries, according to new Johns Hopkins research.

Medicare and Medicaid, for example, are increasingly using 
pay-for-performance formulas to cut doctor's pay when their patients 
develop infections after surgery. But the Johns Hopkins researchers 
say there could be negative unintended consequences, because obese 
patients, who make up about one-third of the population, are at 
significantly greater risk of complications - notably surgical site 
infections - following appendectomy and gallbladder removal surgery 
than non-obese patients. They also cost thousands more dollars to 
treat than the non-obese.

The new research is scheduled to be presented at Digestive Disease 
Week, the nation's largest gastrointestinal medical conference, which 
runs from May 1 to May 5 in New Orleans.

"This is a government policy that promotes patient selection and 
discrimination," says Martin A. Makary, M.D., M.P.H., an associate 
professor of surgery and health policy at the Johns Hopkins 
University School of Medicine, and the study's leader. "The policy 
incentivizes doctors to pass on, stall or delay treatment of obese 
patients, many of whom are minorities."

Makary suggests that the potential discrimination will 
disproportionately affect African-Americans, whose rates of obesity 
are higher than in the white population. An estimated 65 percent of 
African-American women are overweight in the United States compared 
to 20 percent of white men. In this way, Makary says, flawed 
pay-for-performance policies hurt minority populations -- and the 
doctors who treat them -- the most.

Makary says hospitals and doctors should be held responsible for 
preventing surgical complications. But, he says, any 
pay-for-performance system needs to look beyond complication rates 
and take into account the increased risks and costs known to be 
associated with obesity.

"Rewarding providers based on outcomes is good when the outcomes are 
adjusted for case complexity or co-moribidities," Makary says. "But 
it can be discriminatory and create perverse incentives when metrics 
aren't adjusted. And what is the most prevalent and leading 
co-morbidity in America that skews outcome< Hands down, it's obesity."

Makary and his colleagues examined insurance claims for 35,096 
patients who underwent gallbladder removal and 6,854 patients who 
underwent appendectomy from 2002 to 2008. They compared 30-day 
complications as well as total direct medical costs following surgery 
for obese and non-obese patients.

They found that obese patients were 27 percent more likely than 
non-obese patients to have complications following gallbladder 
surgery and 11 percent more likely to have complications following an 
appendectomy. These complications mean obese patients end up costing 
more to treat, with median total inpatient costs for basic 
gallbladder removal $2,978 higher for obese patients, and $1,621 
higher for obese patients who had appendectomy.

Obese patients undergoing appendectomy had longer hospital stays and 
higher rates of reoperation, infection and hemorrhage than non-obese 
patients, the researchers found. Obese patients who had their 
gallbladders removed saw higher rates of blood clots, reoperation and 
infection. Surgery is particularly difficult on obese patients, the 
authors note, especially procedures performed in the abdominal region 
where fat is disproportionately located. Operations in the obese 
often take longer and require larger wounds. Obese patients may also 
present at later stages of disease, making surgery and subsequent 
care more complex.

Other Johns Hopkins faculty members involved in the study include 
Kenzo Hirose, M.D.; Andrew Shore, Ph.D.; Elizabeth Wick, M.D., and 
Jonathan P. Weiner, Dr.P.H.

For more information:
http://www.hopkinsmedicine.org/surgery/faculty/Makary

###
 



Back to top
| Back to home page
Video

White House Live Stream
LIVE VIDEO EVERY SATURDAY
Breaking News
alsharpton Rev. Al Sharpton
9 to 11 am EST
jjackson Rev. Jesse Jackson
10 to noon CST


Video

LIVE BROADCASTS
Sounds Make the News ®
WAOK-Urban
Atlanta - WAOK-Urban
KPFA-Progressive
Berkley / San Francisco - KPFA-Progressive
WVON-Urban
Chicago - WVON-Urban
KJLH - Urban
Los Angeles - KJLH - Urban
WKDM-Mandarin Chinese
New York - WKDM-Mandarin Chinese
WADO-Spanish
New York - WADO-Spanish
WBAI - Progressive
New York - WBAI - Progressive
WOL-Urban
Washington - WOL-Urban

Listen to United Natiosns News