Health Expenditures Among High-Risk Patients After Gastric Bypass and Matched Controls
Health Expenditures Among High-Risk Patients After Gastric Bypass and Matched Controls
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DOI：
10.1001/archsurg.2012.818
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发表时间：
2012-07-01
影响因子：
--
通讯作者：
Arterburn, David E.
中科院分区：
文献类型：
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作者：
Maciejewski, Matthew L.;Livingston, Edward H.;Arterburn, David E.
目的：确定在以老年男性患者为主的多部位队列中，减肥手术是否与降低医疗费用有关。设计：减肥手术的回顾性队列研究。研究对象：847名倾向匹配的退伍军人和来自同一12个退伍军人事务部医疗中心的847名非手术对照受试者。干预：减肥手术。主要结果：截至2006年12月的医疗费用。结果：门诊、住院、在手术前3年，减肥手术病例的总支出呈上升趋势，然后在手术后3年，回归到非手术对照的较低支出水平。结论：根据对以老年男性为主的队列的分析，减肥手术似乎与手术后3年医疗费用的减少无关。
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.