Myers Valerie H, McVay Megan A, Adams Claire E, Barbera Brooke L, Brashear Meghan M, Johnson William D, Boyd Patricia Smith, Brantley Phillip J
Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
South Med J. 2012 Oct;105(10):530-7. doi: 10.1097/SMJ.0b013e318268c76d.
To determine the change in total medical expenditures, total pharmacy expenditures, and subcategories of medical and pharmacy expenditures in obese individuals following weight loss surgery (WLS), and to compare these costs with expenditures in obese individuals not receiving WLS.
Louisiana Office of Group Benefits (OGB), the state-managed health insurer, invited members to be evaluated for insurance-covered WLS. Of 951 obese members who provided written consent to begin the WLS screening process, 40 were selected for surgery. Medical and pharmaceutical claims cost data of the 911 patients who did not have surgery and the 39 individuals who completed surgery were compared over a 2-year presurgical and 6-year postsurgical period.
Total nonpharmacy medical costs were lower for WLS patients compared with non-WLS patients beginning 4 years postsurgery and lasting through 6 years postsurgery. No differences were found between WLS and non-WLS patients in expenditures for most medical subcategories examined, including emergency department, physical and occupational therapy, office visits, and laboratory/pathology; whereas sleep facility and all remaining medical expenditures not represented by a subcategory were lower for WLS patients during some postsurgery years. Total pharmacy costs were lower for WLS participants at 2 and 3 years postsurgery, but these lower costs were not maintained; however, costs remained lower for antidiabetic agents, antihypertensive agents, and dyslipidemic agents through all 6 postsurgery years under study.
The cost of WLS may begin to be recouped within the first 4 years postsurgery with continued effects 6 years postsurgery.
确定减肥手术后肥胖个体的总医疗支出、总药房支出以及医疗和药房支出的子类别变化，并将这些成本与未接受减肥手术的肥胖个体的支出进行比较。
路易斯安那州团体福利办公室（OGB），即州管理的健康保险公司，邀请成员接受保险覆盖的减肥手术评估。在951名书面同意开始减肥手术筛查过程的肥胖成员中，40人被选中进行手术。比较了911名未进行手术的患者和39名完成手术的患者在术前2年和术后6年的医疗和药品索赔成本数据。
减肥手术患者的非药房医疗总成本从术后4年开始低于未接受减肥手术的患者，并持续到术后6年。在大多数检查的医疗子类别支出中，减肥手术患者和未接受减肥手术的患者之间没有差异，包括急诊科、物理和职业治疗、门诊就诊以及实验室/病理学检查；而在术后的某些年份，减肥手术患者的睡眠设施和所有其他未由子类别代表的医疗支出较低。减肥手术参与者在术后2年和3年的总药房成本较低，但这些较低的成本并未持续；然而，在研究的所有术后6年中，抗糖尿病药物、抗高血压药物和降血脂药物的成本仍然较低。
减肥手术的成本可能在术后前4年内开始收回，并在术后6年持续产生影响。
