Livingston Edward H
Department of Surgery, VAMC, Dallas and the Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern School of Medicine, 5323 Harry Hines Blvd., Room E7-126, Dallas, TX 75390-9156, USA.
Am J Surg. 2005 Nov;190(5):816-20. doi: 10.1016/j.amjsurg.2005.07.026.
Weight loss operations are being performed at an exponentially increasing rate. Although highly effective for controlling obesity and its complications, the operations are expensive. The operations are thought to be cost-effective, but there has not been an analysis of the costs associated with these procedures at a national level precluding definitive cost-effectiveness studies useful for policy determination.
The 2001 and 2002 National Inpatient Survey (NIS) was used to establish costs attributable to bariatric surgery. This survey contains discharge information for approximately 20% of all US hospital admissions in any given year. Bariatric procedures were identified by ICD-9-CM procedures codes and diagnostic related group (DRG) 288 (operating room [OR] procedures for obesity).
Of the commonly performed operations, laparoscopic gastric bypass had the lowest hospital charges (19,794 dollars/case) relative to open gastric bypass (22,313 dollars/case) and laparoscopic banding procedures (25,355 dollars/case). Laparoscopic gastric bypass resulted in fewer charges because of a 1-day shorter median length of stay.
These data provide benchmarks for the costs associated with the weight loss procedures commonly performed in the United States. Although laparoscopic gastric bypass is the lease costly approach to bariatric surgery, the fact that costs are lower because of decreased length of stay can be disadvantageous for hospitals reimbursed on a per diem basis.
减肥手术的实施率正呈指数级增长。尽管这些手术在控制肥胖及其并发症方面非常有效，但费用高昂。人们认为这些手术具有成本效益，但尚未在国家层面分析与这些手术相关的成本，这使得无法进行有助于政策制定的确定性成本效益研究。
使用2001年和2002年的全国住院患者调查（NIS）来确定减重手术的成本。该调查包含任何给定年份美国所有住院患者中约20%的出院信息。通过国际疾病分类第九版临床修订本（ICD - 9 - CM）手术编码和诊断相关组（DRG）288（肥胖症的手术室[OR]手术）来识别减重手术。
在常见的手术中，腹腔镜胃旁路手术的住院费用最低（19,794美元/例），相对于开放胃旁路手术（22,313美元/例）和腹腔镜束带手术（25,355美元/例）。腹腔镜胃旁路手术费用较低是因为中位住院时间缩短了1天。
这些数据为美国常见的减肥手术相关成本提供了基准。尽管腹腔镜胃旁路手术是减重手术中成本最低的方法，但由于住院时间缩短导致成本降低这一事实，对于按日计费的医院来说可能不利。
