Financial implications of coverage for laparoscopic adjustable gastric banding
Financial implications of coverage for laparoscopic adjustable gastric banding
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DOI：
10.1016/j.soard.2010.10.011
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发表时间：
2011-05-01
影响因子：
3.1
通讯作者：
Hale, Brent C.
中科院分区：
文献类型：
--
作者：
Finkelstein, Eric A.;Allaire, Benjamin T.;Hale, Brent C.
背景：雇主和保险公司越来越关注为减肥手术提供保险的成本影响。我们试图通过索赔分析来量化腹腔镜可调节胃束带（LAGB）覆盖的成本和潜在成本节约。方法：使用美国医疗保健索赔数据，包括bb17000名LAGB患者和倾向评分匹配的对照组，量化LAGB对总体符合手术条件人群和部分符合手术条件的糖尿病人群的成本和潜在成本节约。匹配的对照组由健康风险评估数据中报告的病态肥胖诊断代码和/或体重指数>35 kg/m(2)的人组成。结果：包括手术前后90天的相关医疗费用，LAGB的平均费用约为2万美元。安置后，与术前支付相比，卫生支出略有减少。在术后期间，LAGB样本保持了这些下降。相比之下，比较样本的付款继续增加。因此，在带放置后大约4年，LAGB覆盖的净成本减少到0。对于糖尿病患者来说，LAGB的净成本在短短20年内就降至0。结论：这些结果表明，LAGB手术在相对较短的时间内就能收回成本，尤其是对糖尿病患者。（外科学杂志2011；7:295-303。）(C) 2011年美国代谢与减肥外科学会。版权所有。
Background: Employers and insurers have become increasingly concerned about the cost implications of providing coverage for bariatric procedures. We sought to quantify the costs and potential cost savings resulting from coverage for laparoscopic adjustable gastric banding (LAGB) using a claims analysis.Methods: U.S. healthcare claims data of >7000 LAGB patients and a propensity score-matched control group were used to quantify the costs and potential cost savings resulting from LAGB for the overall surgery-eligible population and for the subset of the surgery-eligible population with diabetes mellitus. The matched control group consisted of those with a morbid obesity diagnosis code and/or a body mass index >35 kg/m(2) as reported in the Health Risk Assessment data.Results: Including the related medical payments in the 90 days before and after the procedure, the mean cost of LAGB was approximately $20,000. After placement, a modest reduction occurred in the health expenditures relative to the preoperative payments. In the postoperative period, these decreases were maintained for the LAGB sample. In contrast, the payments for the comparison sample continued to increase. As a result, the net cost of coverage for LAGB was reduced to 0 by approximately 4 years after band placement. For those with diabetes, the net costs resulting from LAGB were reduced to 0 in just >2 years.Conclusion: These results suggest that the LAGB procedure pays for itself within a relatively short period, especially for those with diabetes. (Surg Obes Relat Dis 2011;7:295-303.) (C) 2011 American Society for Metabolic and Bariatric Surgery. All rights reserved.