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Beyond Barriers to Access: Association of Socioeconomic Factors with Body-Contouring Outcomes
Henry Huson MD, Kiersten Woodyard De Brito, Susanna Gebhardt, Nathaniel Roberson MD, Ermina Lee
University of Cincinnati
2024-01-15
Presenter: Nathaniel Roberson
Affidavit:
I certify that all of the work being presented is the original work of the residents and medical students listed as authors on this abstract.
Director Name: Ann Schwentker
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Socioeconomic status (SES), income and insurance type have been shown to be associated with disparities in surgical outcomes for breast surgery. This investigation sought to examine SES factors, and if a similar association exists with poor surgical outcomes after panniculectomy.
Methods: A retrospective chart review was conducted for patients who underwent panniculectomy from 2018 to 2022. Data included demographics, co-morbidities, insurance type, and complications. US Census data determined median income for patient zip-code. Zip-codes with median incomes <175% FPL were designated 'low-income', >275% FPL as 'high-income,' and between 175% and 275% FPL were 'average-income.' Comparisons of continuous variables used Welch's t-tests. Categorical comparisons utilized Odds Ratios and Chi-Squared analysis.
Results: 204 patients were examined after exclusion of cosmetic abdominoplasty. Average age was 46.1±12.0 years, and average BMI was 31.2±6.6. Income groups had similar distributions of age, resection weight, BMI, and DM, but Black patients were disproportionately represented in the low-income group (p<0.001). 72 patients had complications (35%). Patients designated low-income were 2.83 (1.33, 6.01) times as likely to have complications compared to those designated high-income (p=0.0067), and 2.32 (1.15, 4.68) times as likely as patients designated average-income (p=0.0192). Patients with at least one complication had an average zip-code designated income of $64,415, compared to $73,576 for patients without complications (p=0.0027).
Conclusions: SES, insurance type, and income have been previously shown to present barriers to accessibility of body-contouring procedures. We demonstrate that SES factors may additionally have a detrimental impact on outcomes due to increased complication rates after panniculectomy.
