Health expenditures among high-risk patients after gastric bypass and matched controls.
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.


METHODS
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.


METHODS
Bariatric surgery programs in VA medical centers.


METHODS
Eight hundred forty-seven veterans who were propensity matched to 847 nonsurgical control subjects from the same 12 VA medical centers.


METHODS
Bariatric surgical procedures.


METHODS
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.
Center for Health Services Research in Primary Care, Durham Veterans Affairs, Durham, NC 27705, USA. matthew.maciejewski@va.gov
Matthew L
ML
Maciejewski
Edward H
EH
Livingston
Valerie A
VA
Smith
Leila C
LC
Kahwati
William G
WG
Henderson
David E
DE
Arterburn
D000328:Adult; D000368:Aged; D000465:Algorithms; D050110:Bariatric Surgery / Q000191:economics*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D005102:Health Expenditures; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000191:economics* / Q000601:surgery*; D057216:Propensity Score; D012189:Retrospective Studies; D012306:Risk; D014481:United States