Lam Edward C F, Murariu Daniel, Takahashi Edwin, Park Chan W, Bueno Racquel S, Lorenzo Cedric S F
ARTEMIS (Association of Research, Training and Education in Minimally Invasive Surgery) Research Group, Department of Surgery, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI 96813, USA.
Hawaii J Med Public Health. 2013 Feb;72(2):40-3.
Native Hawaiians (NH) represent a unique population where socioeconomic factors have contributed to higher incidence rates of obesity and related comorbidities than in the general population resulting in substantial prescription medication costs. Studies demonstrate that laparoscopic Roux-en-y gastric bypass (LRYGB) surgery results in significant weight loss, improvement of comorbidities, and decreased costs for prescription medications in Caucasians. This study aimed to analyze the effects of LRYGB surgery on Native Hawaiians and their prescription drug costs.
Demographics, baseline body mass index (BMI), comorbidities, preoperative, and postoperative data were analyzed for NH patients who underwent LRYGB between January 2004 and April 2009. Medication costs were determined using the online pharmacy http://www.drugstore.com. Generic drugs were selected when appropriate, while vitamins and nutritional supplements were not included in this study.
Fifty (14 Men, 36 women) NH patients had sufficient data and follow-up for analysis. Average preoperative BMI was 49 kg/m(2), while at one year follow-up it decreased to 33 kg/m(2) (P<.001). This correlates to an average of 61% excess body weight lost (P<.001). The average number of prescription medications decreased from 3.5/patient preoperatively to 1.1/patient at one year (P<.001), equating to a monthly cost savings of US $195.8/patient (P<.001).
LRYGB provided substantial weight loss for morbidly obese NH patients, resulting in significantly less prescription medication use and substantial cost savings. Thus, bariatric surgery for weight management has the potential to improve the overall well-being and lower the financial burden of medical care in socioeconomically disadvantaged communities such as the NH.
夏威夷原住民（NH）是一个独特的群体，社会经济因素导致该群体肥胖及相关合并症的发病率高于普通人群，从而产生了高昂的处方药费用。研究表明，腹腔镜Roux-en-y胃旁路术（LRYGB）可使白人体重显著减轻、合并症得到改善且处方药费用降低。本研究旨在分析LRYGB手术对夏威夷原住民及其处方药费用的影响。
对2004年1月至2009年4月期间接受LRYGB手术的NH患者的人口统计学、基线体重指数（BMI）、合并症、术前和术后数据进行分析。使用在线药房http://www.drugstore.com确定药物费用。适当选择通用药物，本研究未包括维生素和营养补充剂。
50例（14例男性，36例女性）NH患者有足够的数据和随访资料用于分析。术前平均BMI为49kg/m²，而在1年随访时降至33kg/m²（P<0.001）。这相当于平均减轻了61%的超重体重（P<0.001）。处方药的平均数量从术前的3.5种/患者降至1年时的1.1种/患者（P<0.001），相当于每位患者每月节省195.8美元（P<0.001）。
LRYGB使病态肥胖的NH患者体重显著减轻，导致处方药使用显著减少并节省了大量费用。因此，减重手术用于体重管理有可能改善社会经济弱势社区（如NH社区）的整体健康状况并减轻医疗护理的经济负担。
