减肥手术：减轻管理式医疗领域中处方费用的经济负担。

Bariatric surgery: shedding the monetary weight of prescription costs in the managed care arena.

作者信息

Potteiger Chad E, Paragi Prakash R, Inverso Nicholas A, Still Christopher, Reed Mary Jane, Strodel William, Rogers Marc, Petrick Anthony

机构信息

Department of Gastroenterology and Nutrition, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA 17822-2111, USA.

出版信息

Obes Surg. 2004 Jun-Jul;14(6):725-30. doi: 10.1381/0960892041590999.

DOI:10.1381/0960892041590999

PMID:15318973

Abstract

BACKGROUND

Prescription costs for treatment of comorbidities associated with morbid obesity is a considerable annual health-care expenditure. This study addressed the effect of Roux-en-Y gastric bypass (RYGBP) on diabetic and anti-hypertensive pharmaceutical utilization and cost savings at our institution.

METHODS

Retrospective data from the electronic database of 51 consecutive patients, who underwent RYGBP from March 2001 to May 2002 were studied. Patients had BMI >40 associated with obesity-related diabetes and hypertension. Prescription medications utilized by this cohort were reviewed preoperatively and at 3- and 9-month intervals postoperatively. Significance was analyzed by paired t-test.

RESULTS

Prevalence of diabetes and hypertension was 55.7% (29/53) and 44.3% (24/53) respectively, and 34% (18/53) patients had both co-morbidities. Preoperatively, patients were on an average of 2.44 +/- 1.86 medications at a cost of 187.24 USD +/- 237.41 USD per month. Postoperatively, the mean number of medications was reduced to 0.56 +/- 0.81 agents (P<0.001) at a monthly cost of 42.53 USD +/- 116.60 (P<0.001).

CONCLUSIONS

RYGBP can decrease the prescription medication requirements, resulting in significant cost-savings in the treatment of obesity-related hypertension and diabetes. This study found a 77.3% reduction in total cost of diabetic and anti-hypertensive medications.

摘要

背景

治疗与病态肥胖相关的合并症的处方费用是一项可观的年度医疗保健支出。本研究探讨了 Roux-en-Y 胃旁路术（RYGBP）对我院糖尿病和抗高血压药物使用及成本节约的影响。

方法

研究了 2001 年 3 月至 2002 年 5 月期间连续 51 例行 RYGBP 的患者电子数据库中的回顾性数据。患者的体重指数（BMI）>40，伴有肥胖相关的糖尿病和高血压。术前及术后 3 个月和 9 个月对该队列使用的处方药进行了评估。采用配对 t 检验分析显著性。

结果

糖尿病和高血压的患病率分别为 55.7%（29/53）和 44.3%（24/53），34%（18/53）的患者同时患有这两种合并症。术前，患者平均服用 2.44±1.86 种药物，每月费用为 187.24 美元±237.41 美元。术后，药物平均数量降至 0.56±0.81 种（P<0.001），每月费用为 42.53 美元±116.60 美元（P<0.001）。