Four-year hospital resource utilization after bariatric surgery: comparison with clinical and surgical controls.

BACKGROUND

Consumption of healthcare has been shown to diminish after bariatric treatment, but utilization of hospital services has not been well documented. Aiming to assess this question, a retrospective study with females was designed.

METHODS

Yearly outpatient appointments, hospital admissions, emergency department visits, and total biochemical tests during 4 years were registered and compared with the preoperative year. Population (N = 176, all females) comprised 94 bariatric candidates submitted to Roux-en-Y gastric bypass (RYGB; age 41.4 ± 10.1 years, BMI 52.2 ± 10.6 kg/m(2)), 34 nonoperated obese controls (age 49.4 ± 8.3 years, BMI 33.8 ± 5.5 kg/m(2)), and 48 colorectal surgical controls (age 44.8 ± 8.6 years, BMI 23.8 ± 4.7 kg/m(2)). Nonbariatric obese patients were fairly well-matched, moderate differences involving higher age and comorbidities. Surgical controls were similarly aged but suffered from less comorbidities.

RESULTS

Obese nonsurgical participants displayed the highest demand for outpatient visits (10.5 ± 0.9/year, P < 0.001) followed by bariatric and colorectal cases (5.7 ± 0.2 and 3.5 ± 0.8, respectively, P = 0.042). Also biochemical measurements were most often required by clinical controls (61.5 ± 5.1/year, P < 0.001), whereas no difference was detected between bariatric and colorectal patients (28.9 ± 2.2 and 33.8 ± 7.7/year, respectively). Elective and emergency admissions were similar for all groups, and part of the postbariatric assistance was related to plastic surgery.

CONCLUSIONS

RYGB patients needed 45.8% less outpatient visits and 53.0% less laboratory tests than nonoperated moderately obese cases, even including esthetic operations. Results were comparable to those observed after elective colorectal surgery and remained fairly stable during 4 years.