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CA Details Bariatric Surgery Trends by Hospital

Cheryl Clark, for HealthLeaders Media, October 27, 2011

For example, the Fresno Heart and Surgical Hospital performs the most bariatric procedures, 878, of any hospital in the state, 878, but 699, or 80%, are done with Lap RYGB. Fresno surgeons only did two open RYGB procedures 10 VSG, 7 BPD and 160 Lap Band.

The second highest volume hospital, Scripps Mercy in San Diego, performed 834, but 94.6% were Lap RYGB.

And at Cedars Sinai Medical Center in Los Angeles, 53.1% of the hospital's 699 bariatric procedures were Lap Band, while at Kaiser Foundation Hospital in Harbor City, 59.3% of 400 procedures were performed as VSG.

The state did not reveal specific death and complication rates for each of the 94 hospitals, which it does for other hospital procedures such as coronary artery bypass grafts. That's because to date, there isn't an acceptable risk-adjustment formula that accurately takes into consideration how sick patients who undergo this procedure really are. However, he says, "it's something we'd eventually like to do" when someone comes up with a well-vetted algorithm.

Parker says the state would like to separate reasons for patient mortality from those related to surgery or post-surgical issues versus unrelated circumstances, such as accidents or violence.

As bariatric procedures are increasingly accepted as a medically sound alternative to dieting and exercise for obese people with one or more co-morbidities, more procedures are being done nationally and in California. For 2010, the number of procedures in the state will reach 14,600. Since 2005, the number of bariatric procedures has risen nearly 7% to 13,500 procedures in 2009.

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