Predictors of high cost after bariatric surgery: A single institution review.

Conference Paper

BACKGROUND: Drivers of high cost care after bariatric operation have not been well described. We sought to compare 1-year costs between patients who underwent laparoscopic vertical sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass and identify predictors of high cost of care. METHODS: Morbidly obese patients who underwent laparoscopic vertical sleeve gastrectomy (n = 74) or laparoscopic Roux-en-Y gastric bypass (n = 270) at a single institution from 2010-2014 were identified. Patient demographic characteristics, surgeon age, 90-day and 1-year surgical outcomes, and facility cost data were collected. "High cost" patients were defined as those in the top quartile of costs among all patients. Variables hypothesized a priori to be associated with high total costs were included in a bivariate logistic regression model. Those with a P value < .1 were included in a multivariable logistic regression model with "high cost" as the outcome. RESULTS: Laparoscopic vertical sleeve gastrectomy was associated with slightly greater median total 1-year costs ($18,234 vs $17,151; P = .021) and inpatient costs ($15,026 vs $13,990; P = .019). On multivariable analysis, having Medicaid (odds ratio 2.72; 95% confidence interval, 1.47-5.06) compared with private insurance, being readmitted to the hospital (odds ratio 5.48; 95% confidence interval, 2.45-12.26), and experiencing a postoperative complication (odds ratio 4.12; 95% confidence interval, 1.79-9.48) were associated with high-cost care. CONCLUSION: Suboptimal operative outcomes seem to be the primary driver of high overall costs after bariatric operation. Improving postoperative outcomes may result in substantial cost savings.

Full Text

Duke Authors

Cited Authors

  • Shah, N; Greenberg, JA; Leverson, G; Funk, LM

Published Date

  • October 2016

Published In

Volume / Issue

  • 160 / 4

Start / End Page

  • 877 - 884

PubMed ID

  • 27521041

Electronic International Standard Serial Number (EISSN)

  • 1532-7361

Digital Object Identifier (DOI)

  • 10.1016/j.surg.2016.06.038

Conference Location

  • United States