Bariatric surgery is not linked to lower costs among individuals with diabetes
Research Activities, November 2012, No. 387
Bariatric surgery is an obesity intervention that produces sustained weight loss and improvement in many obesity-related conditions, including diabetes. However, contradicting previous cost studies, a new study found that individuals with type 2 diabetes did not have lower health care costs after the surgery than before the surgery. The study found total mean costs were $9,326 presurgery, $13,400 during the first year after surgery, and $13,644, 6 years after surgery. The cost increases in the postsurgical period were due primarily to higher inpatient and outpatient costs. There was an increase in inpatient days and a decrease in primary care and specialist visits in the postsurgery periods compared with the presurgery period. Patients with type 2 diabetes are a third of all patients undergoing bariatric surgery.
The study tracked 7,306 privately insured patients (18 to 64 years of age) who received bariatric surgery for 6 years following their surgery. The researchers point out that, even if bariatric surgery is not cost-saving among adults with diabetes, a reduction or elimination of weight-related coexisting conditions, improved quality of life, and improved mobility may make this a valuable procedure for this group of patients.
The researchers call for more studies to determine what conditions and services increase use of health care among this group; to understand whether an increase in elective procedures (e.g., knee replacements, plastic surgery) not available to patients before surgery partially explains increased cost and utilization postsurgery; and to understand clinical determinants of postoperative costs of bariatric surgery among adults with diabetes. This study was supported in part by the Agency for Healthcare Research and Quality (Contract No. 290-05-0034).
See "Impact of bariatric surgery on health care utilization and costs among patients with diabetes" by Sara N. Bleich, PhD, Hsien-Yen Chang, PhD, Bryan Lau, PhD, and others in Medical Care 50, pp. 58-65, 2012.