Seip Richard L, Robey Kyle, Stone Andrea, Chin Geneth, Staff Ilene, McLaughlin Tara, Tishler Darren, Papasavas Pavlos
Hartford Healthcare Surgical Weight Loss Center, Hartford, CT, 06102, USA.
Hartford Hospital Research Program, Hartford, CT, 06102, USA.
Obes Surg. 2019 Jun;29(6):1922-1931. doi: 10.1007/s11695-019-03793-9.
Patients undergoing Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have different healthcare needs after surgery. Our aim was to quantify non-routine healthcare utilization after RYGB vs. SG.
We compared non-routine (NR) visits made and associated services provided up to 2 years post-surgery for patients undergoing RYGB or SG at a Bariatric Surgery Comprehensive Center between March 2013 and April 2015.
A total of 258 and 461 patients had primary RYGB and SG, respectively. Successful follow-up rates at one (76.2%) and 2 years post-surgery (52.6%) did not differ between groups. Rates for all NR visits, expressed as the number per 100 patients, were 68.6 in RYGB vs. 35.4 in SG patients (p < 0.0001). Emergency department visits with subsequent admission (EDA) or without subsequent admission (ED-only) and outpatient visits (OPV) were more frequent in RYGB vs. SG: EDA, 14.7 vs. 8.0 (p = 0.0076); ED-only, 17.8 vs. 7.6 (p = 0.0001); and OPV, 29.8 vs. 14.1 (p < 0.0001). RYGB required more services per 100 patients than SG, 120.9 vs. 75.3, respectively (p < 0.0001). Imaging was the resource most often used overall. Surgery type (RYGB) significantly predicted healthcare utilization even after controlling for gender, ethnicity, and other variables. Healthcare utilization peaked at 1 to 6 months post-surgery, driven by patients who underwent RYGB.
RYGB required twice as many non-routine follow-up visits and 1.6 times greater use of healthcare services relative to SG. Computer-assisted tomography imaging and endoscopies showed the greatest differences. Peak healthcare utilization for RYGB occurred between 1 and 6 months following surgery.
接受Roux-en-Y胃旁路术（RYGB）和袖状胃切除术（SG）的患者术后有不同的医疗保健需求。我们的目的是量化RYGB与SG术后的非例行医疗保健利用率。
我们比较了2013年3月至2015年4月期间在一家减肥手术综合中心接受RYGB或SG手术的患者术后2年内进行的非例行（NR）就诊及相关服务。
分别有258例和461例患者接受了初次RYGB和SG手术。两组术后1年（76.2%）和2年（52.6%）的成功随访率无差异。以每100例患者的就诊次数表示的所有NR就诊率，RYGB患者为68.6次，SG患者为35.4次（p<0.0001）。与SG相比，RYGB患者因急诊就诊后住院（EDA）或未住院（仅急诊）以及门诊就诊（OPV）更为频繁：EDA，14.7次对8.0次（p=0.0076）；仅急诊，17.8次对7.6次（p=0.0001）；OPV，29.8次对14.1次（p<0.0001）。每100例患者中，RYGB所需的服务比SG更多，分别为120.9次对75.3次（p<0.0001）。影像学检查是总体上最常使用的资源。即使在控制了性别、种族和其他变量后，手术类型（RYGB）仍显著预测医疗保健利用率。术后1至6个月医疗保健利用率达到峰值，这是由接受RYGB手术的患者推动的。
与SG相比，RYGB所需的非例行随访就诊次数是其两倍，医疗服务使用率高出1.6倍。计算机断层扫描成像和内镜检查显示出最大差异。RYGB术后医疗保健利用率的峰值出现在术后1至6个月之间。
