Costs and usage of healthcare services before and after open bariatric surgery
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802011000500003 |
Resumo: | CONTEXT AND OBJECTIVE: Morbidly obese individuals are major consumers of healthcare services, with high associated costs. Bariatric surgery is an alternative for improving these individuals' comorbidities. There are no studies comparing costs before and after bariatric surgery in Brazil. The aim here was to analyze results relating to healthcare usage and direct costs among morbidly obese patients undergoing bariatric surgery. DESIGN AND SETTING: Historical cohort study on patients receiving healthcare through a private health plan in Belo Horizonte, Minas Gerais. METHODS: All healthcare services and their associated costs were included in the analysis: hospitalization, hospital stay, elective outpatient consultations, emergency service usage and examinations. The analyses were treated as total when including the whole years before and after surgery, or partial when excluding the three-month periods adjacent to the operation. RESULTS: For 382 obese patients who underwent open bariatric operations, there were 53 hospitalizations one year before and 95 one year after surgery (P = 0.013). Gastrointestinal complications were the main indications for post-procedure hospitalizations. The partial average cost almost doubled after the operation (US$ 391.96 versus US$ 678.31). In subgroup analysis, the costs from patients with gastrointestinal complications were almost four times greater after bariatric surgery. Even in the subgroup without complications, the partial average cost remained significantly higher. CONCLUSION: Although bariatric surgery is the only path towards sustained weight loss for morbidly obese patients, the direct costs over the first year after the procedure are greater. Further studies, with longer follow-up, might elucidate whether long-term reversal of this trend would occur |
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Costs and usage of healthcare services before and after open bariatric surgeryObesity, morbidGastric bypassHealth care costsMorbidityBariatric surgeryCONTEXT AND OBJECTIVE: Morbidly obese individuals are major consumers of healthcare services, with high associated costs. Bariatric surgery is an alternative for improving these individuals' comorbidities. There are no studies comparing costs before and after bariatric surgery in Brazil. The aim here was to analyze results relating to healthcare usage and direct costs among morbidly obese patients undergoing bariatric surgery. DESIGN AND SETTING: Historical cohort study on patients receiving healthcare through a private health plan in Belo Horizonte, Minas Gerais. METHODS: All healthcare services and their associated costs were included in the analysis: hospitalization, hospital stay, elective outpatient consultations, emergency service usage and examinations. The analyses were treated as total when including the whole years before and after surgery, or partial when excluding the three-month periods adjacent to the operation. RESULTS: For 382 obese patients who underwent open bariatric operations, there were 53 hospitalizations one year before and 95 one year after surgery (P = 0.013). Gastrointestinal complications were the main indications for post-procedure hospitalizations. The partial average cost almost doubled after the operation (US$ 391.96 versus US$ 678.31). In subgroup analysis, the costs from patients with gastrointestinal complications were almost four times greater after bariatric surgery. Even in the subgroup without complications, the partial average cost remained significantly higher. CONCLUSION: Although bariatric surgery is the only path towards sustained weight loss for morbidly obese patients, the direct costs over the first year after the procedure are greater. Further studies, with longer follow-up, might elucidate whether long-term reversal of this trend would occurAssociação Paulista de Medicina - APM2011-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802011000500003Sao Paulo Medical Journal v.129 n.5 2011reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/S1516-31802011000500003info:eu-repo/semantics/openAccessKelles,Silvana Marcia BruschiBarreto,Sandhi MariaGuerra,Henrique Leonardoeng2011-11-07T00:00:00Zoai:scielo:S1516-31802011000500003Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2011-11-07T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Costs and usage of healthcare services before and after open bariatric surgery |
title |
Costs and usage of healthcare services before and after open bariatric surgery |
spellingShingle |
Costs and usage of healthcare services before and after open bariatric surgery Kelles,Silvana Marcia Bruschi Obesity, morbid Gastric bypass Health care costs Morbidity Bariatric surgery |
title_short |
Costs and usage of healthcare services before and after open bariatric surgery |
title_full |
Costs and usage of healthcare services before and after open bariatric surgery |
title_fullStr |
Costs and usage of healthcare services before and after open bariatric surgery |
title_full_unstemmed |
Costs and usage of healthcare services before and after open bariatric surgery |
title_sort |
Costs and usage of healthcare services before and after open bariatric surgery |
author |
Kelles,Silvana Marcia Bruschi |
author_facet |
Kelles,Silvana Marcia Bruschi Barreto,Sandhi Maria Guerra,Henrique Leonardo |
author_role |
author |
author2 |
Barreto,Sandhi Maria Guerra,Henrique Leonardo |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Kelles,Silvana Marcia Bruschi Barreto,Sandhi Maria Guerra,Henrique Leonardo |
dc.subject.por.fl_str_mv |
Obesity, morbid Gastric bypass Health care costs Morbidity Bariatric surgery |
topic |
Obesity, morbid Gastric bypass Health care costs Morbidity Bariatric surgery |
description |
CONTEXT AND OBJECTIVE: Morbidly obese individuals are major consumers of healthcare services, with high associated costs. Bariatric surgery is an alternative for improving these individuals' comorbidities. There are no studies comparing costs before and after bariatric surgery in Brazil. The aim here was to analyze results relating to healthcare usage and direct costs among morbidly obese patients undergoing bariatric surgery. DESIGN AND SETTING: Historical cohort study on patients receiving healthcare through a private health plan in Belo Horizonte, Minas Gerais. METHODS: All healthcare services and their associated costs were included in the analysis: hospitalization, hospital stay, elective outpatient consultations, emergency service usage and examinations. The analyses were treated as total when including the whole years before and after surgery, or partial when excluding the three-month periods adjacent to the operation. RESULTS: For 382 obese patients who underwent open bariatric operations, there were 53 hospitalizations one year before and 95 one year after surgery (P = 0.013). Gastrointestinal complications were the main indications for post-procedure hospitalizations. The partial average cost almost doubled after the operation (US$ 391.96 versus US$ 678.31). In subgroup analysis, the costs from patients with gastrointestinal complications were almost four times greater after bariatric surgery. Even in the subgroup without complications, the partial average cost remained significantly higher. CONCLUSION: Although bariatric surgery is the only path towards sustained weight loss for morbidly obese patients, the direct costs over the first year after the procedure are greater. Further studies, with longer follow-up, might elucidate whether long-term reversal of this trend would occur |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802011000500003 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802011000500003 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1516-31802011000500003 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.129 n.5 2011 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209263035613184 |