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BEFORE-AND-AFTER STUDY: DOES BARIATRIC SURGERY REDUCE HEALTHCARE UTILIZATION AND RELATED COSTS AMONG OPERATED PATIENTS?

Published online by Cambridge University Press:  18 January 2016

Silvana Marcia Bruschi Kelles ,
Carla Jorge Machado  and
Sandhi Maria Barreto
Silvana Marcia Bruschi Kelles
Affiliation:
Unimed BH, Health Technology Assessment Group – GATS; Faculdade de Medicina da Universidade Federal de Minas [email protected]
Carla Jorge Machado
Affiliation:
Faculdade de Medicina da Universidade Federal de Minas Gerais, Centro de Pósgraduação
Sandhi Maria Barreto
Affiliation:
Faculdade de Medicina da Universidade Federal de Minas Gerais, Centro de Pósgraduação
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Abstract

Background: Healthcare use and costs are about 81% higher for morbidly obese individuals compared to non-obese persons, and 47% higher compared to the non-morbidly obese population. The benefits of bariatric surgery for health are well established, but its mid-term impact on healthcare use and costs remains controversial.

Methods: This study examines the trends in healthcare use and costs in a Brazilian cohort during a 4-year period before and after surgery. Healthcare use and direct costs related to inpatients and outpatients were retrieved from a healthcare insurance company database from which all cohort members were selected.

Results: Between 2004 and 2010, 4,006 individuals underwent bariatric surgery. Most patients were female (80%) with a mean age of 36.2 years and a mean body mass index of 42.8 kg/m2. Elevated blood pressure was present in 38% of cases and diabetes was found in 12.5% of subjects. Hospital admissions increased consistently after surgery, even after excluding hospitalizations for esthetic surgery and pregnancy-related care. The most prevalent conditions in this group were gastrointestinal diseases. Emergency department visits increased after bariatric procedures, in particular for genitourinary and hematologic problems. Adjusted costs were higher after surgery as assessed during a 4-year follow-up period.

Conclusion: Results indicate that costs and hospital admissions after bariatric surgery increase following this procedure, even when elective interventions are excluded. Healthcare providers and policy makers need to be aware that a decrease in obesity-related diseases following bariatric surgery does not reduce healthcare use and costs.

Keywords

Cost analysisHealthcare services evaluationBariatric surgeryFollow-up studiesMorbid obesity
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 31 , Issue 6 , 2015 , pp. 407 - 413
Copyright
Copyright © Cambridge University Press 2016 

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References

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