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

Publication ,  Conference
Shah, N; Greenberg, JA; Leverson, G; Funk, LM
Published in: Surgery
October 2016

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.

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Published In

Surgery

DOI

EISSN

1532-7361

Publication Date

October 2016

Volume

160

Issue

4

Start / End Page

877 / 884

Location

United States

Related Subject Headings

  • United States
  • Surgery
  • Retrospective Studies
  • Predictive Value of Tests
  • Postoperative Care
  • Obesity, Morbid
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Shah, N., Greenberg, J. A., Leverson, G., & Funk, L. M. (2016). Predictors of high cost after bariatric surgery: A single institution review. In Surgery (Vol. 160, pp. 877–884). United States. https://doi.org/10.1016/j.surg.2016.06.038
Shah, Neil, Jacob A. Greenberg, Glen Leverson, and Luke M. Funk. “Predictors of high cost after bariatric surgery: A single institution review.” In Surgery, 160:877–84, 2016. https://doi.org/10.1016/j.surg.2016.06.038.
Shah N, Greenberg JA, Leverson G, Funk LM. Predictors of high cost after bariatric surgery: A single institution review. In: Surgery. 2016. p. 877–84.
Shah, Neil, et al. “Predictors of high cost after bariatric surgery: A single institution review.Surgery, vol. 160, no. 4, 2016, pp. 877–84. Pubmed, doi:10.1016/j.surg.2016.06.038.
Shah N, Greenberg JA, Leverson G, Funk LM. Predictors of high cost after bariatric surgery: A single institution review. Surgery. 2016. p. 877–884.
Journal cover image

Published In

Surgery

DOI

EISSN

1532-7361

Publication Date

October 2016

Volume

160

Issue

4

Start / End Page

877 / 884

Location

United States

Related Subject Headings

  • United States
  • Surgery
  • Retrospective Studies
  • Predictive Value of Tests
  • Postoperative Care
  • Obesity, Morbid
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models