Health Care Use During 20 Years Following Bariatric Surgery
CONTEXT Bariatric surgery results in sustained weight loss; reduced incidence of diabetes, cardiovascular events, and cancer; and improved survival. The long-term effect on health care use is unknown. OBJECTIVE To assess health care use over 20 years by obese patients treated conventionally or with...
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| creator | Neovius, Martin Narbro, Kristina Keating, Catherine Peltonen, Markku Sjöholm, Kajsa Ågren, Göran Sjöström, Lars Carlsson, Lena |
| description | CONTEXT Bariatric surgery results in sustained weight loss; reduced incidence of diabetes, cardiovascular events, and cancer; and improved survival. The long-term effect on health care use is unknown. OBJECTIVE To assess health care use over 20 years by obese patients treated conventionally or with bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS The Swedish Obese Subjects study is an ongoing, prospective, nonrandomized, controlled intervention study conducted in the Swedish health care system that included 2010 adults who underwent bariatric surgery and 2037 contemporaneously matched controls recruited between 1987 and 2001. Inclusion criteria were age 37 years to 60 years and body mass index of 34 or higher in men and 38 or higher in women. Exclusion criteria were identical in both groups. INTERVENTIONS Of the surgery patients, 13% underwent gastric bypass, 19% gastric banding, and 68% vertical-banded gastroplasty. Controls received conventional obesity treatment. MAIN OUTCOME MEASURES Annual hospital days (follow-up years 1 to 20; data capture 1987-2009; median follow-up 15 years) and nonprimary care outpatient visits (years 2-20; data capture 2001-2009; median follow-up 9 years) were retrieved from the National Patient Register, and drug costs from the Prescribed Drug Register (years 7-20; data capture 2005-2011; median follow-up 6 years). Registry linkage was complete for more than 99% of patients (4044 of 4047). Mean differences were adjusted for baseline age, sex, smoking, diabetes status, body mass index, inclusion period, and (for the inpatient care analysis) hospital days the year before the index date. RESULTS In the 20 years following their bariatric procedure, surgery patients used a total of 54 mean cumulative hospital days compared with 40 used by those in the control group (adjusted difference, 15; 95% CI, 2-27; P = .03). During the years 2 through 6, surgery patients had an accumulated annual mean of 1.7 hospital days vs 1.2 days among control patients (adjusted difference, 0.5; 95% CI, 0.2 to 0.7; P |
| doi_str_mv | 10.1001/2012.jama.11792 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_534524</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>1360866</ama_id><sourcerecordid>2775095441</sourcerecordid><originalsourceid>FETCH-LOGICAL-a491t-b9048b9980eab26668107e997c931a00e414a088088fdac9c4064e314a95bf43</originalsourceid><addsrcrecordid>eNp90UFrFDEUB_Agit1Wz4IHGZCCl9m-l2QyCZ50tVYoeLAePIU30zfrrLM722RD6bc3464reDAEEh6_vCT8hXiBMEcAvJCAcr6iNc0RaycfiRlWypaqcvaxmAE4W9ba6hNxGuMK8kBVPxUnUjoHspYz8faKadj9KBYUuPgWufiQQr9ZFhKK70whFpfjMIz3U-k9hZ52oW-LryksOTw8E086GiI_P6xn4uby483iqrz-8unz4t11SdrhrmwcaNs4Z4GpkcYYi1Czc3XrFBIAa9QE1ubZ3VLrWg1Gs8pFVzWdVmei3LeN97xNjd-Gfk3hwY_U-0PpZ96xr5Su5P_9Mm19Li3T5NFUDuvs3-z9Nox3iePOr_vY8jDQhscUPYJGJbVxNtPX_9DVmMImfz4ri1oZK1VWF3vVhjHGwN3xCQh-is1PsfkpNv87tnzi1aFvatZ8e_R_csrg_AAotjR0gTZtH_86oypUMLmXezf1Pt6qDFhj1C84nKXK</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1081436823</pqid></control><display><type>article</type><title>Health Care Use During 20 Years Following Bariatric Surgery</title><source>MEDLINE</source><source>American Medical Association Journals</source><source>SWEPUB Freely available online</source><creator>Neovius, Martin ; Narbro, Kristina ; Keating, Catherine ; Peltonen, Markku ; Sjöholm, Kajsa ; Ågren, Göran ; Sjöström, Lars ; Carlsson, Lena</creator><creatorcontrib>Neovius, Martin ; Narbro, Kristina ; Keating, Catherine ; Peltonen, Markku ; Sjöholm, Kajsa ; Ågren, Göran ; Sjöström, Lars ; Carlsson, Lena</creatorcontrib><description>CONTEXT Bariatric surgery results in sustained weight loss; reduced incidence of diabetes, cardiovascular events, and cancer; and improved survival. The long-term effect on health care use is unknown. OBJECTIVE To assess health care use over 20 years by obese patients treated conventionally or with bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS The Swedish Obese Subjects study is an ongoing, prospective, nonrandomized, controlled intervention study conducted in the Swedish health care system that included 2010 adults who underwent bariatric surgery and 2037 contemporaneously matched controls recruited between 1987 and 2001. Inclusion criteria were age 37 years to 60 years and body mass index of 34 or higher in men and 38 or higher in women. Exclusion criteria were identical in both groups. INTERVENTIONS Of the surgery patients, 13% underwent gastric bypass, 19% gastric banding, and 68% vertical-banded gastroplasty. Controls received conventional obesity treatment. MAIN OUTCOME MEASURES Annual hospital days (follow-up years 1 to 20; data capture 1987-2009; median follow-up 15 years) and nonprimary care outpatient visits (years 2-20; data capture 2001-2009; median follow-up 9 years) were retrieved from the National Patient Register, and drug costs from the Prescribed Drug Register (years 7-20; data capture 2005-2011; median follow-up 6 years). Registry linkage was complete for more than 99% of patients (4044 of 4047). Mean differences were adjusted for baseline age, sex, smoking, diabetes status, body mass index, inclusion period, and (for the inpatient care analysis) hospital days the year before the index date. RESULTS In the 20 years following their bariatric procedure, surgery patients used a total of 54 mean cumulative hospital days compared with 40 used by those in the control group (adjusted difference, 15; 95% CI, 2-27; P = .03). During the years 2 through 6, surgery patients had an accumulated annual mean of 1.7 hospital days vs 1.2 days among control patients (adjusted difference, 0.5; 95% CI, 0.2 to 0.7; P < .001). From year 7 to 20, both groups had a mean annual 1.8 hospital days (adjusted difference, 0.0; 95% CI, −0.3 to 0.3; P = .95). Surgery patients had a mean annual 1.3 nonprimary care outpatient visits during the years 2 through 6 vs 1.1 among the controls (adjusted difference, 0.3; 95% CI, 0.1 to 0.4; P = .003), but from year 7, the 2 groups did not differ (1.8 vs 1.9 mean annual visits; adjusted difference, −0.2; 95% CI, −0.4 to 0.1; P = .12). From year 7 to 20, the surgery group incurred a mean annual drug cost of US $930; the control patients, $1123 (adjusted difference, −$228; 95% CI, −$335 to −$121; P < .001). CONCLUSIONS Compared with controls, surgically treated patients used more inpatient and nonprimary outpatient care during the first 6-year period after undergoing bariatric surgery but not thereafter. Drug costs from years 7 through 20 were lower for surgery patients than for control patients. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01479452</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/2012.jama.11792</identifier><identifier>PMID: 22990272</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Ambulatory Care - utilization ; Bariatric Surgery ; Biological and medical sciences ; Case-Control Studies ; Drug Costs - statistics & numerical data ; Female ; Follow-Up Studies ; Gastrointestinal surgery ; General aspects ; Health care ; Health Services - utilization ; Hospitalization - statistics & numerical data ; Humans ; Kirurgi ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Obesity ; Obesity - economics ; Obesity - surgery ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Stomach, duodenum, intestine, rectum, anus ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Sweden</subject><ispartof>JAMA : the journal of the American Medical Association, 2012-09, Vol.308 (11), p.1132-1141</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright American Medical Association Sep 19, 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a491t-b9048b9980eab26668107e997c931a00e414a088088fdac9c4064e314a95bf43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/2012.jama.11792$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/2012.jama.11792$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,230,314,550,776,780,881,3326,27903,27904,76236,76239</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26351302$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22990272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/165917$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:125199329$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Neovius, Martin</creatorcontrib><creatorcontrib>Narbro, Kristina</creatorcontrib><creatorcontrib>Keating, Catherine</creatorcontrib><creatorcontrib>Peltonen, Markku</creatorcontrib><creatorcontrib>Sjöholm, Kajsa</creatorcontrib><creatorcontrib>Ågren, Göran</creatorcontrib><creatorcontrib>Sjöström, Lars</creatorcontrib><creatorcontrib>Carlsson, Lena</creatorcontrib><title>Health Care Use During 20 Years Following Bariatric Surgery</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Bariatric surgery results in sustained weight loss; reduced incidence of diabetes, cardiovascular events, and cancer; and improved survival. The long-term effect on health care use is unknown. OBJECTIVE To assess health care use over 20 years by obese patients treated conventionally or with bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS The Swedish Obese Subjects study is an ongoing, prospective, nonrandomized, controlled intervention study conducted in the Swedish health care system that included 2010 adults who underwent bariatric surgery and 2037 contemporaneously matched controls recruited between 1987 and 2001. Inclusion criteria were age 37 years to 60 years and body mass index of 34 or higher in men and 38 or higher in women. Exclusion criteria were identical in both groups. INTERVENTIONS Of the surgery patients, 13% underwent gastric bypass, 19% gastric banding, and 68% vertical-banded gastroplasty. Controls received conventional obesity treatment. MAIN OUTCOME MEASURES Annual hospital days (follow-up years 1 to 20; data capture 1987-2009; median follow-up 15 years) and nonprimary care outpatient visits (years 2-20; data capture 2001-2009; median follow-up 9 years) were retrieved from the National Patient Register, and drug costs from the Prescribed Drug Register (years 7-20; data capture 2005-2011; median follow-up 6 years). Registry linkage was complete for more than 99% of patients (4044 of 4047). Mean differences were adjusted for baseline age, sex, smoking, diabetes status, body mass index, inclusion period, and (for the inpatient care analysis) hospital days the year before the index date. RESULTS In the 20 years following their bariatric procedure, surgery patients used a total of 54 mean cumulative hospital days compared with 40 used by those in the control group (adjusted difference, 15; 95% CI, 2-27; P = .03). During the years 2 through 6, surgery patients had an accumulated annual mean of 1.7 hospital days vs 1.2 days among control patients (adjusted difference, 0.5; 95% CI, 0.2 to 0.7; P < .001). From year 7 to 20, both groups had a mean annual 1.8 hospital days (adjusted difference, 0.0; 95% CI, −0.3 to 0.3; P = .95). Surgery patients had a mean annual 1.3 nonprimary care outpatient visits during the years 2 through 6 vs 1.1 among the controls (adjusted difference, 0.3; 95% CI, 0.1 to 0.4; P = .003), but from year 7, the 2 groups did not differ (1.8 vs 1.9 mean annual visits; adjusted difference, −0.2; 95% CI, −0.4 to 0.1; P = .12). From year 7 to 20, the surgery group incurred a mean annual drug cost of US $930; the control patients, $1123 (adjusted difference, −$228; 95% CI, −$335 to −$121; P < .001). CONCLUSIONS Compared with controls, surgically treated patients used more inpatient and nonprimary outpatient care during the first 6-year period after undergoing bariatric surgery but not thereafter. Drug costs from years 7 through 20 were lower for surgery patients than for control patients. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01479452</description><subject>Adult</subject><subject>Ambulatory Care - utilization</subject><subject>Bariatric Surgery</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Drug Costs - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastrointestinal surgery</subject><subject>General aspects</subject><subject>Health care</subject><subject>Health Services - utilization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Kirurgi</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Obesity</subject><subject>Obesity - economics</subject><subject>Obesity - surgery</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Sweden</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp90UFrFDEUB_Agit1Wz4IHGZCCl9m-l2QyCZ50tVYoeLAePIU30zfrrLM722RD6bc3464reDAEEh6_vCT8hXiBMEcAvJCAcr6iNc0RaycfiRlWypaqcvaxmAE4W9ba6hNxGuMK8kBVPxUnUjoHspYz8faKadj9KBYUuPgWufiQQr9ZFhKK70whFpfjMIz3U-k9hZ52oW-LryksOTw8E086GiI_P6xn4uby483iqrz-8unz4t11SdrhrmwcaNs4Z4GpkcYYi1Czc3XrFBIAa9QE1ubZ3VLrWg1Gs8pFVzWdVmei3LeN97xNjd-Gfk3hwY_U-0PpZ96xr5Su5P_9Mm19Li3T5NFUDuvs3-z9Nox3iePOr_vY8jDQhscUPYJGJbVxNtPX_9DVmMImfz4ri1oZK1VWF3vVhjHGwN3xCQh-is1PsfkpNv87tnzi1aFvatZ8e_R_csrg_AAotjR0gTZtH_86oypUMLmXezf1Pt6qDFhj1C84nKXK</recordid><startdate>20120919</startdate><enddate>20120919</enddate><creator>Neovius, Martin</creator><creator>Narbro, Kristina</creator><creator>Keating, Catherine</creator><creator>Peltonen, Markku</creator><creator>Sjöholm, Kajsa</creator><creator>Ågren, Göran</creator><creator>Sjöström, Lars</creator><creator>Carlsson, Lena</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>F1U</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20120919</creationdate><title>Health Care Use During 20 Years Following Bariatric Surgery</title><author>Neovius, Martin ; Narbro, Kristina ; Keating, Catherine ; Peltonen, Markku ; Sjöholm, Kajsa ; Ågren, Göran ; Sjöström, Lars ; Carlsson, Lena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a491t-b9048b9980eab26668107e997c931a00e414a088088fdac9c4064e314a95bf43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Ambulatory Care - utilization</topic><topic>Bariatric Surgery</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Drug Costs - statistics & numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastrointestinal surgery</topic><topic>General aspects</topic><topic>Health care</topic><topic>Health Services - utilization</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Kirurgi</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Obesity</topic><topic>Obesity - economics</topic><topic>Obesity - surgery</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Sweden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Neovius, Martin</creatorcontrib><creatorcontrib>Narbro, Kristina</creatorcontrib><creatorcontrib>Keating, Catherine</creatorcontrib><creatorcontrib>Peltonen, Markku</creatorcontrib><creatorcontrib>Sjöholm, Kajsa</creatorcontrib><creatorcontrib>Ågren, Göran</creatorcontrib><creatorcontrib>Sjöström, Lars</creatorcontrib><creatorcontrib>Carlsson, Lena</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neovius, Martin</au><au>Narbro, Kristina</au><au>Keating, Catherine</au><au>Peltonen, Markku</au><au>Sjöholm, Kajsa</au><au>Ågren, Göran</au><au>Sjöström, Lars</au><au>Carlsson, Lena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Health Care Use During 20 Years Following Bariatric Surgery</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2012-09-19</date><risdate>2012</risdate><volume>308</volume><issue>11</issue><spage>1132</spage><epage>1141</epage><pages>1132-1141</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Bariatric surgery results in sustained weight loss; reduced incidence of diabetes, cardiovascular events, and cancer; and improved survival. The long-term effect on health care use is unknown. OBJECTIVE To assess health care use over 20 years by obese patients treated conventionally or with bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS The Swedish Obese Subjects study is an ongoing, prospective, nonrandomized, controlled intervention study conducted in the Swedish health care system that included 2010 adults who underwent bariatric surgery and 2037 contemporaneously matched controls recruited between 1987 and 2001. Inclusion criteria were age 37 years to 60 years and body mass index of 34 or higher in men and 38 or higher in women. Exclusion criteria were identical in both groups. INTERVENTIONS Of the surgery patients, 13% underwent gastric bypass, 19% gastric banding, and 68% vertical-banded gastroplasty. Controls received conventional obesity treatment. MAIN OUTCOME MEASURES Annual hospital days (follow-up years 1 to 20; data capture 1987-2009; median follow-up 15 years) and nonprimary care outpatient visits (years 2-20; data capture 2001-2009; median follow-up 9 years) were retrieved from the National Patient Register, and drug costs from the Prescribed Drug Register (years 7-20; data capture 2005-2011; median follow-up 6 years). Registry linkage was complete for more than 99% of patients (4044 of 4047). Mean differences were adjusted for baseline age, sex, smoking, diabetes status, body mass index, inclusion period, and (for the inpatient care analysis) hospital days the year before the index date. RESULTS In the 20 years following their bariatric procedure, surgery patients used a total of 54 mean cumulative hospital days compared with 40 used by those in the control group (adjusted difference, 15; 95% CI, 2-27; P = .03). During the years 2 through 6, surgery patients had an accumulated annual mean of 1.7 hospital days vs 1.2 days among control patients (adjusted difference, 0.5; 95% CI, 0.2 to 0.7; P < .001). From year 7 to 20, both groups had a mean annual 1.8 hospital days (adjusted difference, 0.0; 95% CI, −0.3 to 0.3; P = .95). Surgery patients had a mean annual 1.3 nonprimary care outpatient visits during the years 2 through 6 vs 1.1 among the controls (adjusted difference, 0.3; 95% CI, 0.1 to 0.4; P = .003), but from year 7, the 2 groups did not differ (1.8 vs 1.9 mean annual visits; adjusted difference, −0.2; 95% CI, −0.4 to 0.1; P = .12). From year 7 to 20, the surgery group incurred a mean annual drug cost of US $930; the control patients, $1123 (adjusted difference, −$228; 95% CI, −$335 to −$121; P < .001). CONCLUSIONS Compared with controls, surgically treated patients used more inpatient and nonprimary outpatient care during the first 6-year period after undergoing bariatric surgery but not thereafter. Drug costs from years 7 through 20 were lower for surgery patients than for control patients. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01479452</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>22990272</pmid><doi>10.1001/2012.jama.11792</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | JAMA : the journal of the American Medical Association, 2012-09, Vol.308 (11), p.1132-1141 |
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| subjects | Adult Ambulatory Care - utilization Bariatric Surgery Biological and medical sciences Case-Control Studies Drug Costs - statistics & numerical data Female Follow-Up Studies Gastrointestinal surgery General aspects Health care Health Services - utilization Hospitalization - statistics & numerical data Humans Kirurgi Male Medical sciences Middle Aged Miscellaneous Obesity Obesity - economics Obesity - surgery Public health. Hygiene Public health. Hygiene-occupational medicine Stomach, duodenum, intestine, rectum, anus Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Sweden |
| title | Health Care Use During 20 Years Following Bariatric Surgery |
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