Obesity Surgery Costs and Complications On The Decline

June 11th, 2009

Bariatric surgery complication rates in the United States declined 21% between 2001 and 2006, and costs to hospitals decreased by as much as 13% for bariatric surgery patients during the same time period, partly because fewer complications meant fewer readmissions, a new study reports.

The findings from the study by the U.S. Agency for Healthcare Research and Quality (AHRQ), “Recent Improvements in Bariatric Surgery Outcomes” published in the May 2009 Medical Care, are based on an analysis of more than 9,500 patients under age 65 who had weight loss surgery at 652 hospitals between 2001 and 2002 and between 2005 and 2006.

Results of the study showed that the bariatric surgery complications dropped from approximately 24% to roughly 15%, driven primarily by a reduction in the post-surgical infection rate by 58% and a reduction in abdominal hernias, staple leakage, respiratory failure and pneumonia by 29% to 50%. Rates for other complications, such as ulcers, dumping (when sugars go directly from your stomach pouch into the small intestine causing heart palpitations, nausea, abdominal pain and diarrhea), hemorrhage, wound reopening, deep-vein thrombosis and pulmonary embolism, heart attacks and strokes, remained relatively unchanged.

Between 2001 and 2006, hospital costs for bariatric surgery patients as a whole fell from $29,563 to $27,905. For patients who experienced complications, this number dropped from $41,807 to $38,175. Hospital costs for the most expensive patients—those who had to be readmitted because of complications—fell from $80,001 to $69,960.

Among the other findings:

• Complications fell even though there were more older and sicker patients undergoing surgery. During the study period, the proportion of patients over age 50 having surgery for obesity increased from 28% to 44%, and the average number of weight-related health conditions – such as diabetes, high blood pressure, and sleep apnea – in bariatric surgery patients more than doubled.

• The six-month post-surgical death rate remained at about 0.5% during the study period.

• Hospital readmissions due to complications fell from 10% to 7%, and complication-caused, same-day hospital outpatient visits fell from 15% to 13%.

According to the researchers, the improvements are largely due to a combination of three factors—increased use of laparoscopy, a technology that allows physicians to operate through small incisions; increased use of banding procedures without gastric bypass, such as the LAP-BAND® System; and increased surgeon experience arising from the growth in the number of bariatric surgeries performed by hospitals.

Source: U.S. Agency for Healthcare Research and Quality, news release, April 29, 2009. Available at http://www.ahrq.gov/news/press/pr2009/barsurgpr.htm. Accessed June 2, 2009.

Entry Filed under: Lap Band, Obesity Today, Realize Band, gastric bypass