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Health expenditures among high-risk patients after gastric bypass and matched controls
Maciejewski, M. L., Livingston, E. H., Smith, V. A., Kahwati, L. C., Henderson, W. G., & Arterburn, D. E. (2012). Health expenditures among high-risk patients after gastric bypass and matched controls. JAMA Surgery, 147(7), 633-640. https://doi.org/10.1001/archsurg.2012.818
OBJECTIVE: To determine whether bariatric surgery is associated with reduced health care expenditures in a multisite cohort of predominantly older male patients with a substantial disease burden.
DESIGN: Retrospective cohort study of bariatric surgery. Outpatient, inpatient, and overall health care expenditures within Department of Veterans Affairs (VA) medical centers were examined via generalized estimating equations in the propensity-matched cohorts.
SETTING: Bariatric surgery programs in VA medical centers.
PARTICIPANTS: Eight hundred forty-seven veterans who were propensity matched to 847 nonsurgical control subjects from the same 12 VA medical centers.
INTERVENTION: Bariatric surgical procedures.
MAIN OUTCOME MEASURE: Health expenditures through December 2006.
RESULTS: Outpatient, inpatient, and total expenditures trended higher for bariatric surgical cases in the 3 years leading up to the procedure and then converged back to the lower expenditure levels of nonsurgical controls in the 3 years after the procedure.
CONCLUSIONS: Based on analyses of a cohort of predominantly older men, bariatric surgery does not appear to be associated with reduced health care expenditures 3 years after the procedure.
