Background

Racial and ethnic disparities in obesity abound and preoperative bariatric surgery patient attrition remains high. Withdrawal from a program may be exacerbated by racial, economic, education, or other factors. We must identify barriers to attrition and access to care to begin to narrow the health inequities in people with obesity seeking surgical care. We aimed to evaluate the preoperative bariatric attrition within our program for language, racial and economic disparities to identify areas for improvement in programming and outreach.

Methods

We identified all patients who started an evaluation at our surgical center from 2022 and 2023 and compared the demographics of those who completed surgery and those who did not. Language, religion, insurance status and surgeon language were analyzed.

Results

A total of 643 patients were included in the study. 323 (50.2%) did not complete surgery and 320 (49.8%) completed surgery. There was no significant difference in preferred language or insurance status between patients who completed surgery and those who did not. Patients categorized as 'Some Other Race' (n=110, 17.1%) were less likely to make it to surgery (85(26.35) vs. 25(7.8%). p = <0.001) compared to patients who indicated a race on the intake form. 'Some Other Race' include Bangladeshi, Barbadian, West Indian, Filipino, Honduran, Jamaican and Other, of which 46 (55%) are on Medicare or Medicaid.

Conclusions

Identifying actionable disparities and barriers to successful completion of bariatric surgery program relies on inclusive data collection and abstraction. Over generalization or categorization may mask disparities and exacerbate healthcare inequities.