Outcomes, Health Status, and Medical Resource Utilization After Bariatric Surgery

Abstract

Surgical results, economic consequences, and shortterm health of obese patients were evaluated before and after bariatric surgery. Of 35 patients in Mayo Health Plan Arizona eligible for bariatric surgery and scheduled for gastric restriction with Roux-en-Y gastrojejunostomy, 22 (7 men, 15 women) completed pre- and postoperative (6- and 12-mo) short form (SF)-12 Health Surveys. Nineteen patients had open bariatric procedures and 3 had laparoscopic procedures. Comorbid conditions, hospital course, weight loss, and complications were examined. Health care utilization (actual dollars paid by plan) for the preceding year and at 1- and 2-yr follow-up were compared. Major comorbid conditions included diabetes mellitus or impaired fasting glucose, hyperlipidemia, sleep apnea, and hypertension. Mean length of hospital stay was 4.8 d after open procedures and 2 d after laparoscopic procedures. No serious operative or postoperative complications occurred. From a baseline average body mass index (BMI) of 51.9, the 6- and 12-mo BMI averages were 39.6 (23.7% decrease) and 35.3 (32% decrease), respectively. Both physical and mental status improved. From baseline, physical health changed 18 and 21.2 points at 6 and 12 mo, respectively (p < 0.001), and mental health changed 9.3 points at each interval (p =0.003). Each postoperative year, resource utilization decreased (mean= $1300 per patient). Our findings of good surgical outcomes, significant weight loss, improved health status, and potential financial savings in this small sample may help patients, insurers, and self-funded employer groups evaluate the appropriateness of bariatric procedures.

Impact of Bariatric Surgery on Health Care Utilization and Costs Among Patients With Diabetes

“…This study contradicts previous research showing cost savings after bariatric surgery in a general population (17–18) and among individuals with type 2 diabetes (10, 19) as well as research showing that bariatric surgery is cost-effective among the severely obese with diabetes (20). It is consistent with recent research showing higher health care expenditures after bariatric surgery (21) and higher hospital use after Roux-en-Y gastric bypass (22).…”

Diverse approaches to the health economic evaluation of bariatric surgery: a comprehensive systematic review

“…Fifty six percent ( n = 43) of studies' data is predominantly is sourced from or originated from the USA . Studies also originated from Sweden 10% ( n = 8), Australia 8% ( n = 6), UK 8% ( n = 6), Canada , and the remainder of the included studies each for France ( n = 2),Germany , (Austria, Italy, Spain) , Spain , Norway , Portugal , the Netherlands , Finland , South Korea , Brazil ( n = 2) and Mexico .…”

Bariatric procedures as day/short stay surgery: is it possible and reasonable?

“…This relative low fulfilment of demand may be challenged in the future by the favourable long-term results and good overall economy with this type of surgery. In a 1-year follow-up of 35 bariatric Roux-en-Y patients, Gorman et al [5] demonstrated good surgical outcome, significant weight loss (i.e., 35%), improved physical and mental health status, and an annual US$1300 saving in health expenditure per operated patient. Their results [5] are confirmed by the study of Myers and coworkers [6 ], who found a 53% weight reduction and considerable improvements in quality of life.…”