Impact of bariatric surgery on health care utilization and costs among patients with diabetes

Research output: Contribution to journalArticle

Abstract

Background: The effect of bariatric surgery on health care utilization and costs among individuals with type 2 diabetes remains unclear. Objective:: To examine health care utilization and costs in an insured cohort of individuals with type 2 diabetes after bariatric surgery. Research Design: Cohort study derived from administrative data from 2002 to 2008 from 7 Blue Cross Blue Shield Plans. Participants: Seven thousand eight hundred six individuals with type 2 diabetes who had bariatric surgery. Measures: Cost (inpatient, outpatient, pharmacy, and others) and utilization (number of inpatient days, outpatient visits, specialist visits). Results: Compared with presurgical costs, the ratio of hospital costs (excluding the initial surgery), among beneficiaries who had any hospital costs, was higher in years 2 through 6 of the postsurgery period and increased over time [post 1: odds ratio (OR)=0.58; 95% confidence interval (CI), 0.50-0.67; post 6: OR=3.43; 95% CI, 2.60-4.53]. In comparison with the presurgical period, the odds of having any health care costs was lower in the postsurgery period and remained relatively flat over time. Among those with hospitalizations, the adjusted ratio of inpatient days was higher after surgery (post 1: OR=1.05; 95% CI, 0.94-1.16; post 6: OR=2.77; 95% CI, 1.57-4.90). Among those with primary care visits, the adjusted OR was lower after surgery (post 1: OR=0.80; 95% CI, 0.78-0.82; post 6: OR=0.66; 95% CI, 0.57-0.76). Conclusions: In the 6 years after surgery, individuals with type 2 diabetes did not have lower health care costs than before surgery.

Original languageEnglish (US)
Pages (from-to)58-65
Number of pages8
JournalMedical Care
Volume50
Issue number1
DOIs
StatePublished - Jan 2012

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Patient Acceptance of Health Care
Bariatric Surgery
Health Care Costs
Odds Ratio
Confidence Intervals
Type 2 Diabetes Mellitus
Blue Cross Blue Shield Insurance Plans
Inpatients
Hospital Costs
Outpatients
Costs and Cost Analysis
Primary Health Care
Hospitalization
Cohort Studies
Research Design

Keywords

  • bariatric surgery
  • cost
  • healthcare utilization
  • type 2 diabetes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

@article{bcb5daf2e74e4de0afeec5ee15add92c,
title = "Impact of bariatric surgery on health care utilization and costs among patients with diabetes",
abstract = "Background: The effect of bariatric surgery on health care utilization and costs among individuals with type 2 diabetes remains unclear. Objective:: To examine health care utilization and costs in an insured cohort of individuals with type 2 diabetes after bariatric surgery. Research Design: Cohort study derived from administrative data from 2002 to 2008 from 7 Blue Cross Blue Shield Plans. Participants: Seven thousand eight hundred six individuals with type 2 diabetes who had bariatric surgery. Measures: Cost (inpatient, outpatient, pharmacy, and others) and utilization (number of inpatient days, outpatient visits, specialist visits). Results: Compared with presurgical costs, the ratio of hospital costs (excluding the initial surgery), among beneficiaries who had any hospital costs, was higher in years 2 through 6 of the postsurgery period and increased over time [post 1: odds ratio (OR)=0.58; 95{\%} confidence interval (CI), 0.50-0.67; post 6: OR=3.43; 95{\%} CI, 2.60-4.53]. In comparison with the presurgical period, the odds of having any health care costs was lower in the postsurgery period and remained relatively flat over time. Among those with hospitalizations, the adjusted ratio of inpatient days was higher after surgery (post 1: OR=1.05; 95{\%} CI, 0.94-1.16; post 6: OR=2.77; 95{\%} CI, 1.57-4.90). Among those with primary care visits, the adjusted OR was lower after surgery (post 1: OR=0.80; 95{\%} CI, 0.78-0.82; post 6: OR=0.66; 95{\%} CI, 0.57-0.76). Conclusions: In the 6 years after surgery, individuals with type 2 diabetes did not have lower health care costs than before surgery.",
keywords = "bariatric surgery, cost, healthcare utilization, type 2 diabetes",
author = "Bleich, {Sara N} and Hsien-Yen Chang and Lau, {Bryan M} and Kimberley Steele and Jeanne Clark and Thomas Richards and Jonathan Weiner and Wu, {Albert W} and Jodi Segal",
year = "2012",
month = "1",
doi = "10.1097/MLR.0b013e3182290349",
language = "English (US)",
volume = "50",
pages = "58--65",
journal = "Medical Care",
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T1 - Impact of bariatric surgery on health care utilization and costs among patients with diabetes

AU - Bleich, Sara N

AU - Chang, Hsien-Yen

AU - Lau, Bryan M

AU - Steele, Kimberley

AU - Clark, Jeanne

AU - Richards, Thomas

AU - Weiner, Jonathan

AU - Wu, Albert W

AU - Segal, Jodi

PY - 2012/1

Y1 - 2012/1

N2 - Background: The effect of bariatric surgery on health care utilization and costs among individuals with type 2 diabetes remains unclear. Objective:: To examine health care utilization and costs in an insured cohort of individuals with type 2 diabetes after bariatric surgery. Research Design: Cohort study derived from administrative data from 2002 to 2008 from 7 Blue Cross Blue Shield Plans. Participants: Seven thousand eight hundred six individuals with type 2 diabetes who had bariatric surgery. Measures: Cost (inpatient, outpatient, pharmacy, and others) and utilization (number of inpatient days, outpatient visits, specialist visits). Results: Compared with presurgical costs, the ratio of hospital costs (excluding the initial surgery), among beneficiaries who had any hospital costs, was higher in years 2 through 6 of the postsurgery period and increased over time [post 1: odds ratio (OR)=0.58; 95% confidence interval (CI), 0.50-0.67; post 6: OR=3.43; 95% CI, 2.60-4.53]. In comparison with the presurgical period, the odds of having any health care costs was lower in the postsurgery period and remained relatively flat over time. Among those with hospitalizations, the adjusted ratio of inpatient days was higher after surgery (post 1: OR=1.05; 95% CI, 0.94-1.16; post 6: OR=2.77; 95% CI, 1.57-4.90). Among those with primary care visits, the adjusted OR was lower after surgery (post 1: OR=0.80; 95% CI, 0.78-0.82; post 6: OR=0.66; 95% CI, 0.57-0.76). Conclusions: In the 6 years after surgery, individuals with type 2 diabetes did not have lower health care costs than before surgery.

AB - Background: The effect of bariatric surgery on health care utilization and costs among individuals with type 2 diabetes remains unclear. Objective:: To examine health care utilization and costs in an insured cohort of individuals with type 2 diabetes after bariatric surgery. Research Design: Cohort study derived from administrative data from 2002 to 2008 from 7 Blue Cross Blue Shield Plans. Participants: Seven thousand eight hundred six individuals with type 2 diabetes who had bariatric surgery. Measures: Cost (inpatient, outpatient, pharmacy, and others) and utilization (number of inpatient days, outpatient visits, specialist visits). Results: Compared with presurgical costs, the ratio of hospital costs (excluding the initial surgery), among beneficiaries who had any hospital costs, was higher in years 2 through 6 of the postsurgery period and increased over time [post 1: odds ratio (OR)=0.58; 95% confidence interval (CI), 0.50-0.67; post 6: OR=3.43; 95% CI, 2.60-4.53]. In comparison with the presurgical period, the odds of having any health care costs was lower in the postsurgery period and remained relatively flat over time. Among those with hospitalizations, the adjusted ratio of inpatient days was higher after surgery (post 1: OR=1.05; 95% CI, 0.94-1.16; post 6: OR=2.77; 95% CI, 1.57-4.90). Among those with primary care visits, the adjusted OR was lower after surgery (post 1: OR=0.80; 95% CI, 0.78-0.82; post 6: OR=0.66; 95% CI, 0.57-0.76). Conclusions: In the 6 years after surgery, individuals with type 2 diabetes did not have lower health care costs than before surgery.

KW - bariatric surgery

KW - cost

KW - healthcare utilization

KW - type 2 diabetes

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