Acute Care Utilization and Costs Up to 4 Years After Index Sleeve Gastrectomy or Roux-en-Y Gastric Bypass: A National Claims-based Study.

Szczegóły
Abstrakt

Tytuł:: Acute Care Utilization and Costs Up to 4 Years After Index Sleeve Gastrectomy or Roux-en-Y Gastric Bypass: A National Claims-based Study.
Autorzy:: Callaway Kim K; Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical, School, Boston, Massachusetts.
Argetsinger S; Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical, School, Boston, Massachusetts.
Wharam JF; Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical, School, Boston, Massachusetts.
Zhang F; Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical, School, Boston, Massachusetts.
Arterburn DE; Kaiser Permanente Washington Health Research Institute, Seattle,Washington.
Fernandez A; Department of Surgery,Wake Forest University Health Sciences,Winston-Salem, North Carolina.
Ross-Degnan D; Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical, School, Boston, Massachusetts.
Wallace J; Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical, School, Boston, Massachusetts.
Lewis KH; Department of Surgery,Wake Forest University Health Sciences,Winston-Salem, North Carolina.; Department of Epidemiology and Prevention, Department of Implementation Science, Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina.
Źródło:: Annals of surgery [Ann Surg] 2023 Jan 01; Vol. 277 (1), pp. e78-e86. Date of Electronic Publication: 2021 Jun 07.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
MeSH Terms:: Gastric Bypass*/methods
Obesity, Morbid*/surgery
Adult ; Humans ; Hospitalization ; Gastrectomy/methods ; Emergency Service, Hospital ; Retrospective Studies ; Treatment Outcome
References:: Thereaux J, Lesuffleur T, Czernichow S, et al. Long-term adverse events after sleeve gastrectomy or gastric bypass: a 7-year nationwide, observational, population-based, cohort study. Lancet Diabetes Endocrinol. 2019;7:786–795.
Lewis KH, Arterburn DE, Callaway K, et al. Risk of operative and nonoperative interventions up to 4 years after Roux-en-Y gastric bypass vs vertical sleeve gastrectomy in a nationwide US Commercial Insurance Claims Database. JAMA Netw Open. 2019;2:e1917603.
Kizy S, Jahansouz C, Downey MC, et al. National trends in bariatric surgery 2012-2015: demographics, procedure selection, readmissions, and cost. Obes Surg. 2017;27:2933–2939.
Telem D, Yang J, Altieri M, et al. Rates and risk factors for unplanned emergency department utilization and hospital readmission following bariatric surgery. Ann of Surg. 2016;263:956–960.
Macht R, George J, Ameli O, et al. Factors associated with bariatric postoperative emergency department visits. Surg Obes Relat Dis. 2016;12:1826–1831.
Mora-Pinzon MC, Henkel D, Miller RE, et al. Emergency department visits and readmissions within 1 year of bariatric surgery: a statewide analysis using hospital discharge records. Surgery. 2017;162:1155–1162.
Chen J, Mackenzie J, Zhai Y, et al. Preventing returns to the emergency department followingbariatric surgery. Obes Surg. 2017;27:1986–1992.
Seip RL, Robey K, Stone A, et al. Comparison of non-routine healthcare utilization in the 2 years following Roux-En-Y gastric bypass and sleeve gastrectomy: a cohort study. Obes Surg. 2019;29:1922–1931.
Berger ER, Huffman KM, Fraker T, et al. Prevalence and risk factors for bariatric surgery readmissions: findings from 130,007 admissions in the metabolic and bariatric surgery accreditation and quality improvement program. Ann Surg. 2018;267:122–131.
Chaar ME, Lundberg P, Stoltzfus J. Thirty-day outcomes of sleeve gastrectomy versus Roux-en-Y gastric bypass: first report based on Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Related Dis. 2018;14:545–551.
Dorman RB, Miller CJ, Leslie DB, et al. Risk for hospital readmission following bariatric surgery. PLoS One. 2012;7:e32506.
Garg T, Rosas U, Rogan D, et al. Characterizing readmissions after bariatric surgery. J Gastrointest Surg. 2016;20:1797–1801.
Khorgami Z, Andalib A, Aminian A, et al. Predictors of readmission after laparoscopic gastric bypass and sleeve gastrectomy: a comparative analysis of ACS-NSQIP database;.
Sippey M, Kasten KR, Chapman WHH, et al. 30-day readmissions after sleeve gastrectomy versus Roux-en-Y gastric bypass. Surg Obes Related Dis. 2016;12:991–996.
Rios-Diaz AJ, Metcalfe D, Devin CL, et al. Six-month readmissions after bariatric surgery: results of a nationwide analysis. Surgery. 2019;166: 926–933.
Courcoulas A, Coley RY, Clark JM, et al. Interventions and operations 5 years after bariatric surgery in a cohort from the US national patient-centered clinical research network bariatric study. JAMA Surg. 2020;155:194–204.
Spaniolas K, Goldberg I, Yang J, et al. Hospital utilization 4 years after bariatric surgery: sleeve gastrectomy versus Roux-en-Y gastric bypass. Surg Obes Related Dis. 2019;15:1465–1472.
Bolen SD, Chang H-Y, Weiner JP, et al. Clinical outcomes after bariatric surgery: a five-year matched cohort analysis in seven US states. Obes Surg. 2012;22:749–763.
Bruze G, Ottosson J, Neovius M, et al. Hospital admission after gastric bypass: a nationwide cohort study with up to 6 years follow-up. Surg Obes Relat Dis. 2017;13:962–969.
Morgan DJR, Ho KM, Armstrong J, et al. Long-term clinical outcomes and health care utilization after bariatric surgery: a population-based study. Ann Surg. 2015;262:86–92.
Neovius M, Narbro K, Keating C, et al. Health care use during 20 years following bariatric surgery. JAMA. 2012;308:1132–1141.
Bhatti JA, Nathens AB, Thiruchelvam D, et al. Weight loss surgery and subsequent emergency care use: a population-based cohort study. Am J Emerg Med. 2016;34:861–865.
Altieri MS, Yang J, Groves D, et al. Sleeve gastrectomy: the first 3 years: evaluation of emergency department visits, readmissions, and reoperations for 14,080 patients in New York State. Surg Endosc. 2018;32:1209–1214.
Lewis KH, Zhang F, Arterburn DE, et al. Comparing medical costs and use after laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass. JAMA Surg. 2015;150:787–794.
Banerjee S, Garrison LP, Flum DR, et al. Cost and health care utilization implications of bariatric surgery versus intensive lifestyle and medical intervention for type 2 diabetes. Obesity (Silver Spring). 2017;25:1499–1508.
Keating C, Neovius M, Sjöholm K, et al. Healthcare costs during 15 years after bariatric surgery for patients with different baseline glucose status. Lancet Diabetes Endocrinol. 2015;3:855–865.
Smith VA, Arterburn DE, Berkowitz TSZ, et al. Association between bariatric surgery and long-term health care expenditures among veterans with severe obesity. JAMA Surg. 2019;154:e193732–e193732.
Weiner JP, Goodwin SM, Chang H-Y, et al. Impact of bariatric surgery on health care costs of obese persons: a 6-year follow-up of surgical and comparison cohorts using health plan data. JAMA Surg. 2013;148:555–561.
Kovacs Z, Valentin JB, Nielsen RE. Risk of psychiatric disorders, self-harm behaviour and service use associated with bariatric surgery. Acta Psychiatr Scand. 2017;135:149–158.
Sole-Smith V. When You're Told You’re Too Fat to Get Pregnant. The New York Times. Published June 18, 2019. Available at https://www.nytimes.com/2019/06/18/magazine/fertility-weight-obesity-ivf.html. Accessed July 10, 2020.
Wang Y, Deng Z, Meng J, et al. Impact of bariatric surgery on inpatient complication, cost, and length of stay following total hip or knee arthroplasty. J Arthroplasty. 2019;34:2884–2889. e4.
Lewis KH, Arterburn DE, Zhang F, et al. Comparative effectiveness of vertical sleeve gastrectomy versus Roux En Y gastric bypass for diabetes treatment: a claims-based cohort study. Ann Surg. 2019;13:1476–1483.
Krieger N, Chen JT, Waterman PD, et al. Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures-the public health disparities geocoding project. Am J Public Health. 2003;93:1655–1671.
Fiscella K, Fremont AM. Use of geocoding and surname analysis to estimate race and ethnicity. Health Serv Res. 2006;41(4 Pt 1):1482–1500.
Ethnic Technologies. https://www.ethnictechnologies.com Accessed June 3, 2020.
Bureau UC. American Community Survey (ACS). The United States Census Bureau. https://www.census.gov/programs-surveys/acs. Accessed June 3, 2020.
Johns Hopkins ACG System. https://www.hopkinsacg.org/ Accessed June 16, 2020.
Li X, Lewis KH, Callaway K, et al. Suitability of administrative claims databases for bariatric surgery research–is the glass half-full or half-empty? BMC Med Res Methodol. 2020;20:225.
Iacus SM, King G, Porro G. Causal inference without balance checking: coarsened exact matching. Polit Anal. 2012;20:1–24.
Yang D, Dalton JE. A Unified Approach to Measuring the Effect Size between Two Groups Using SAS®.
Is the 80/20 Rule of Health Care Still True? | Deloitte US. Deloitte United States. Available at: https://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/articles/is-80-20-rule-of-health-care-still-true-population-value-based.html. Accessed July 9, 2020.
Pfuntner A, Wier LM. Costs for Hospital Stays in the United States, 2010. 11.
ER spending among the commercially insured continued to rise in 2016, driven by the price and use of high severity cases (2009-2016). HCCI. Available at: https://healthcostinstitute.org/emergency-room/er-spending-among-the-commercially-insured-continued-to-rise-in-2016-driven-by-the-price-and-use-of-high-severity-cases-2009-2016. Accessed July 20, 2020.
Telem DA, Talamini M, Gesten F, et al. Hospital admissions greater than 30 days following bariatric surgery: patient and procedure matter. Surg Endosc. 2015;29:1310–1315.
Della Penna A, Lange J, Hilbert J, et al. Ursodeoxycholic acid for 6 months after bariatric surgery is impacting gallstone associated morbidity in patients with preoperative asymptomatic gallstones. Obes Surg. 2019;29:1216–1221.
Lewis KH, Callaway K, Argetsinger S, et al. Concurrent hiatal hernia repair and bariatric surgery: outcomes after sleeve gastrectomy and Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2021;17:72–80.
Kim J, Simper S, McKinlay R, et al. Healthcare cost and utilization of bariatric surgical patients with and without preoperative mental health diagnoses. Surg Obes Relat Dis. 2020;16:682–689.
Lloret-Linares C, Bellivier F, Heron K, et al. Treating mood disorders in patients with a history of intestinal surgery: a systematic review. Int Clin Psychopharmacol. 2015;30:119–128.
O’Brien PE, Hindle A, Brennan L, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg. 2019;29:3–14.
Grant Information:: R01 DK112750 United States DK NIDDK NIH HHS
Entry Date(s):: Date Created: 20210608 Date Completed: 20230228 Latest Revision: 20230228
Update Code:: 20240104
PubMed Central ID:: PMC8648857
DOI:: 10.1097/SLA.0000000000004972
PMID:: 34102668
: Czasopismo naukowe

Objective: To compare acute care utilization and costs following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).
Summary Background Data: Comparing postbariatric emergency department (ED) and inpatient care use patterns could assist with procedure choice and provide insights about complication risk.
Methods: We used a national insurance claims database to identify adults undergoing SG and RYGB between 2008 and 2016. Patients were matched on age, sex, calendar-time, diabetes, and baseline acute care use. We used adjusted Cox proportional hazards to compare acute care utilization and 2-part logistic regression models to compare annual associated costs (odds of any cost, and odds of high costs, defined as ≥80th percentile), between SG and RYGB, overall and within several clinical categories.
Results: The matched cohort included 4263 SG and 4520 RYGB patients. Up to 4 years after surgery, SG patients had slightly lower risk of ED visits [adjusted hazard ratio (aHR): 0.90; 95% confidence interval (CI): 0.85,0.96] and inpatient stays (aHR: 0.80; 95% CI: 0.73,0.88), especially for events associated with digestive-system diagnoses (ED aHR: 0.68; 95% CI: 0.62,0.75; inpatient aHR: 0.61; 95% CI: 0.53,0.72). SG patients also had lower odds of high ED and high total acute costs (eg, year-1 acute costs adjusted odds ratio (aOR) 0.77; 95% CI: 0.66,0.90) in early follow-up. However, observed cost differences decreased by years 3 and 4 (eg, year-4 acute care costs aOR 1.10; 95% CI: 0.92,1.31).
Conclusions: SG may have fewer complications requiring emergency care and hospitalization, especially as related to digestive system disease. However, any acute care cost advantages of SG may wane over time.
(Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)

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