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The treatment of morbid obesity is eminently multidisciplinary. Interaction between surgeons, obesity physicians, dietitians and psychologists has led to improved clinical care. One of the main factors influencing outcome improvement has been centralization in high-volume centers.
Currently, the designation of a center of excellence is based on its accreditation. In North America, in 2006 the National Coverage Decision Insurance Medicare was approved, and one of the statutes regarding bariatric surgery was that the costs were only covered in accredited hospitals. This type of decision was based on several studies that concluded that the results in accredited centers were significantly better in terms of mortality, reoperations, complications, readmissions, and costs.
The Metabolic and bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), based on the records of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS), has more than 850 centers across the United States, Canada, Abu Dhabi, Jordan, Lebanon, Saudi Arabia, and Puerto Rico. The MBSAQIP program has proven to be a robust method for data recording and center auditing, both at the perioperative level and in the follow-up years.
In this talk, Dr. Abdelrahman A. Nimeri explains the history of ACS NSQIP and MBSAQIP registries, as well as some of the main studies on the effect of accredited bariatric surgery centers on postoperative outcomes. He also explains the process to become a center of excellence, the applications that must be completed, and the type of training that must be carried out. Finally, he talks about some of the annual evaluations specified in the MBSAQIP report about quality improvement.
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