Background

Psychosocial risk factors impacting MBS outcomes are often unexplored. The current study examined the association of two risk factors (health numeracy and insurance type) with MBSAQIP predictions.

Methods

141 surgery-seeking patients from North Mississippi Medical Center Bariatric Clinic (BMI M = 47.36 (+- 7.46); 76.6% female) were referred for pre-surgical psychological evaluations, where they completed a questionnaire about health numeracy (The Brief Medical Numbers Test; BMNT). Their insurance type (private vs. public) and MBSAQIP-predicted outcomes were also recorded. Correlations among all variables were examined, and regression analyses using BMNT and insurance status as predictors of MBSAQIP scores were also conducted.

Results

Health numeracy was associated with 30-day complications (r=-.18) and insurance type (r=-.19). Insurance type was associated with numerous variables, including: serious complications (r=.51), 30-day complications (r=.44), hospital readmission (r=.36), reoperation (r=.33), and 1-year weight reduction (r=-.21; all ps<.001). BMNT scores only significantly predicted 30-day complication estimates (b=-.22; p<.001). Insurance type significantly predicted all scores (bs between -11.01-1.13), with public insurance status predicting worse outcomes.

Conclusions

Lower health numeracy was associated with 30-day complications and insurance status was associated with all MBSAQIP outcomes. Given the brevity of the BMNT (4 items), assessment of health numeracy may be clinically feasible, which could facilitate integration of services for patients who score lower. Similarly, programs could be developed for those with public insurance, whose social disadvantages and potentially limited health awareness could impair their long-term outcomes.