Health Expenditures Among High-Risk Patients After Gastric Bypass and Matched Controls | JAMA Surgery | JAMA Network
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Original Article
July 2012

Health Expenditures Among High-Risk Patients After Gastric Bypass and Matched Controls

Matthew L. Maciejewski, PhD; Edward H. Livingston, MD, MS; Valerie A. Smith, MS; et al Leila C. Kahwati, MD, MPH; William G. Henderson, MPH, PhD; David E. Arterburn, MD, MPH
Author Affiliations Article Information

Author Affiliations: Center for Health Services Research in Primary Care, Durham Veterans Affairs (VA) Medical Center (Dr Maciejewski and Ms Smith), Division of General Internal Medicine, Department of Medicine, Duke University (Dr Maciejewski), and National Center for Health Promotion and Disease Prevention, Office of Patient Care Services, Veterans Health Administration (Dr Kahwati), Durham, North Carolina; Division of Gastrointestinal and Endocrine Surgery, The University of Texas Southwestern Medical Center, and VA North Texas Health Care System, Dallas, Texas (Dr Livingston); Biomedical Engineering Graduate Program, The University of Texas, Arlington (Dr Livingston); Denver VA Medical Center, Denver, Colorado (Dr Henderson); Department of Biostatistics, School of Public Health, and Colorado Health Outcomes Program, University of Colorado, Aurora (Dr Henderson); and Group Health Research Institute and Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle (Dr Arterburn).

Arch Surg. 2012;147(7):633-640. doi:10.1001/archsurg.2012.818
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Abstract

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.

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