July 26, 2012
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Health care costs remain high for bariatric surgery patients 3 years after procedure

Older patients who underwent bariatric surgery can have increased health care expenditures compared with controls for several years after the procedure, according to recent results.

In a retrospective cohort study, researchers evaluated the care expenditures of 847 patients (mean age, 49.5 years; 73.9% men) who underwent bariatric surgery at 12 Veterans Affairs medical centers, along with those of 847 matched controls (mean age, 49 years; 73.7% men). Incorporated costs included outpatient, inpatient and overall expenditures.

Before bariatric surgery, outpatient expenditures differed between patients and controls, with patients averaging $123 more than controls (P=.31) 36 to 31 months before the procedure but $2,758 more (P<.001) in the 6 months leading to surgery. This difference grew smaller again in the 3 years following surgery, with costs $1,223 higher for patients in the first 6 months (P<.001) and $40 higher (P=.82) after 31 to 36 months.

Inpatient costs averaged $694 less for patients (P=.18) 36 to 31 months before surgery, but $25,645 higher (P<.001) 3 months prior, due to admission costs. Following the procedure, patients paid an average of $3,033 more than controls (P<.001) in the first 6 months, and $45 more (P=.90) after 31 to 36 months.

Average overall health care expenditures were $595 lower for patients compared with controls (P=.26) at 36 to 31 months presurgery and rose to $28,400 higher (P<.001) 6 months before and including surgery. Costs remained $4,397 higher 6 months after the procedure (P<.001) and became comparable (P=.75) 31 to 36 months later.

Matthew L. Maciejewski, PhD

Matthew L. Maciejewski

“We conducted this research to provide evidence about this sample, for which there was little prior work,” researcher Matthew L. Maciejewski, PhD, of the division of general internal medicine at Duke University Medical Center, told Healio.com. “These results suggest that the economic benefits of bariatric surgery may not be realized as quickly in patients like these. There are some real health benefits that were realized in these patients; they just don’t translate into cost savings in a 3-year time.”

Disclosure: See the study for a full list of relevant disclosures.