Analysis of Cost Outliers after Gastric Bypass Surgery: What can we Learn?

Cooney, Robert N.; Haluck, Randy S.; Ku, James; Bass, Thomas M.; MacLeod, J. P.; Brunner, Heather; Miller, Cynthia A.

doi:10.1381/096089203321136557

Cited by 31 publications

(13 citation statements)

References 25 publications

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“…15 Complications after other surgical procedures increase costs 16 and patient disability, 17 have an adverse impact on long-term survival, 18 and may be expected after GBP as well. Consequently, prevention and proper treatment of complications should be continuously pursued, a task that requires a clear understanding of the spectrum of complications that occur after GBP as well as their risk factors.…”

Section: Commentmentioning

confidence: 99%

Spectrum and Risk Factors of Complications After Gastric Bypass

Campos

Ciovica²,

Rogers³

et al. 2007

Arch Surg

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Main Outcome Measures: Complications were stratified by grade: grade I, only bedside procedure; grade II, therapeutic intervention but without lasting disability; grade III, irreversible deficits; and grade IV, death. Data were analyzed using logistic regression to identify independent risk factors of complications after GBP. Predictors investigated were age, race, sex, marital and insurance status, body mass index, obesity-associated comorbidities, American Society of Anesthesiologists Physical Status Class, operating room time, open or laparoscopic approach, and surgeon experience. Results: Of the 404 morbidly obese patients who underwent consecutive open (n = 72) or laparoscopic (n = 332) GBP, 74 (18.3%) experienced 107 complications. Grade I and II complications were more frequent after open GBP (grade I, 19.4% after open vs 3.9% after laparoscopic operations, PϽ .001; grade II, 20.8% after open vs 8.4% after laparoscopic operations, PϽ.001), and 55% were wound related. Grades III and IV complications occurred in only 4 patients (1%), and frequency was similar for open and laparoscopic cases. Three factors were independently predictive of complications: diabetes mellitus

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Section: Commentmentioning

confidence: 99%

Spectrum and Risk Factors of Complications After Gastric Bypass

Campos

Ciovica²,

Rogers³

et al. 2007

Arch Surg

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“…Morbidity and complications after surgery prolong hospital stay and are associated with significantly increased cost in hospital care [7,[10][11][12][13][14][15].…”

mentioning

confidence: 99%

Determinants of resource utilization and outcomes in laparoscopic Roux-en-Y gastric bypass: a multicenter analysis of 14,251 patients

et al. 2011

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“…This situation underscores the need for additional research and clearer communication of available findings to the broader medical community and the public at large. Because it generates significant improvement in comorbid diseases, surgical treatment of severe obesity may be more cost-effective over the long term than either currently available nonsurgical methods or no treatment (41)(42)(43). From both clinical and economic perspectives, individuals with a BMI Ͼ 40 kg/m 2 , who are at the greatest risk for pathological complications and premature mortality, are the ones who are likely to benefit most (39,40).…”

Section: Discussionmentioning

confidence: 99%

Coding and Reimbursement for Weight Loss Surgery: Best Practice Recommendations

et al. 2005

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Coding and reimbursement for weight loss surgery: best practice recommendations. Obes Res. 2005;13:290 -300. Objective: To review the use and usefulness of billing codes for services related to weight loss surgery (WLS) and to examine third party reimbursement policies for these services. Research Methods and Procedures:The Task Group carried out a systematic search of MEDLINE, the Internet, and the trade press for publications on WLS, coding, reimbursement, and coding and reimbursement policy. Twenty-eight articles were each reviewed and graded using a system based on established evidence-based models. The Massachusetts Dietetics Association provided reimbursement data for nutrition services. Three suppliers of laparoscopic WLS equipment provided summaries of coding and reimbursement information. WLS program directors were surveyed for information on use of procedure codes related to WLS. Results: Recommendations focused on correcting or improving on the current lack of congruity among coding practices, reimbursement policies, and accepted clinical practice; lack of uniform coding and reimbursement data across institutions; inconsistent and/or inaccurate diagnostic and billing codes; inconsistent insurance reimbursement criteria; and inability to leverage reimbursement and coding data to track outcomes, identify best practices, and perform accurate risk-benefit analyses. Discussion: Rapid changes in the prevalence of obesity, our understanding of its clinical impact, and the technologies for surgical treatment have yet to be adequately reflected in coding, coverage, and reimbursement policies. Issues identified as key to effective change include improved characterization of the risks, benefits, and costs of WLS; anticipation and monitoring of technological advances; encouragement of consistent patterns of insurance coverage; and promotion of billing codes for WLS procedures that facilitate accurate tracking of clinical use and outcomes.

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Analysis of Cost Outliers after Gastric Bypass Surgery: What can we Learn?

Cited by 31 publications

References 25 publications

Spectrum and Risk Factors of Complications After Gastric Bypass

Spectrum and Risk Factors of Complications After Gastric Bypass

Determinants of resource utilization and outcomes in laparoscopic Roux-en-Y gastric bypass: a multicenter analysis of 14,251 patients

Coding and Reimbursement for Weight Loss Surgery: Best Practice Recommendations

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