title: Four-year hospital resource utilization after bariatric surgery: comparison with clinical and surgical controls.
abstract: BACKGROUND
  Consumption of healthcare has been shown to diminish after bariatric treatment, but utilization of hospital services has not been well documented. Aiming to assess this question, a retrospective study with females was designed.
  
  
  METHODS
  Yearly outpatient appointments, hospital admissions, emergency department visits, and total biochemical tests during 4 years were registered and compared with the preoperative year. Population (N = 176, all females) comprised 94 bariatric candidates submitted to Roux-en-Y gastric bypass (RYGB; age 41.4 ± 10.1 years, BMI 52.2 ± 10.6 kg/m(2)), 34 nonoperated obese controls (age 49.4 ± 8.3 years, BMI 33.8 ± 5.5 kg/m(2)), and 48 colorectal surgical controls (age 44.8 ± 8.6 years, BMI 23.8 ± 4.7 kg/m(2)). Nonbariatric obese patients were fairly well-matched, moderate differences involving higher age and comorbidities. Surgical controls were similarly aged but suffered from less comorbidities.
  
  
  RESULTS
  Obese nonsurgical participants displayed the highest demand for outpatient visits (10.5 ± 0.9/year, P < 0.001) followed by bariatric and colorectal cases (5.7 ± 0.2 and 3.5 ± 0.8, respectively, P = 0.042). Also biochemical measurements were most often required by clinical controls (61.5 ± 5.1/year, P < 0.001), whereas no difference was detected between bariatric and colorectal patients (28.9 ± 2.2 and 33.8 ± 7.7/year, respectively). Elective and emergency admissions were similar for all groups, and part of the postbariatric assistance was related to plastic surgery.
  
  
  CONCLUSIONS
  RYGB patients needed 45.8% less outpatient visits and 53.0% less laboratory tests than nonoperated moderately obese cases, even including esthetic operations. Results were comparable to those observed after elective colorectal surgery and remained fairly stable during 4 years.
authors.affiliation: Department of Gastroenterology, Hospital das Clinicas, ICHC, São Paulo, São Paulo, Brazil.
authors.forename: Silvia Yoko
authors.initials: SY
authors.lastname: Hayashi
authors.forename: Joel
authors.initials: J
authors.lastname: Faintuch
authors.forename: Joao Italo Dias
authors.initials: JI
authors.lastname: França
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000328:Adult; D003954:Diagnostic Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies