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Original Article |

Health Expenditures Among High-Risk Patients After Gastric Bypass and Matched Controls

Matthew L. Maciejewski, PhD; Edward H. Livingston, MD, MS; Valerie A. Smith, MS; Leila C. Kahwati, MD, MPH; William G. Henderson, MPH, PhD; David E. Arterburn, MD, MPH
Arch Surg. 2012;147(7):633-640. doi:10.1001/archsurg.2012.818.
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Objective  To determine whether bariatric surgery is associated with reduced health care expenditures in a multisite cohort of predominantly older male patients with a substantial disease burden.

Design  Retrospective cohort study of bariatric surgery. Outpatient, inpatient, and overall health care expenditures within Department of Veterans Affairs (VA) medical centers were examined via generalized estimating equations in the propensity-matched cohorts.

Setting  Bariatric surgery programs in VA medical centers.

Participants  Eight hundred forty-seven veterans who were propensity matched to 847 nonsurgical control subjects from the same 12 VA medical centers.

Intervention  Bariatric surgical procedures.

Main Outcome Measure  Health expenditures through December 2006.

Results  Outpatient, inpatient, and total expenditures trended higher for bariatric surgical cases in the 3 years leading up to the procedure and then converged back to the lower expenditure levels of nonsurgical controls in the 3 years after the procedure.

Conclusions  Based on analyses of a cohort of predominantly older men, bariatric surgery does not appear to be associated with reduced health care expenditures 3 years after the procedure.

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Figures

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Grahic Jump Location

Figure 1. Trends in predicted outpatient US Department of Veterans Affairs expenditures for surgical patients and nonsurgical control subjects. P values are given below each measurement of time from the index date.

Place holder to copy figure label and caption
Grahic Jump Location

Figure 2. Trends in predicted inpatient US Department of Veterans Affairs expenditures for surgical patients and nonsurgical control subjects. P values are given below each measurement of time from the index date.

Place holder to copy figure label and caption
Grahic Jump Location

Figure 3. Trends in predicted overall US Department of Veterans Affairs expenditures for surgical patients and nonsurgical control subjects. P values are given below each measurement of time from the index date.

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Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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