The impact of bariatric surgery on the Veterans Administration healthcare system: a cost analysis

• Published in: Obesity surgery Vol. 13; no. 2; pp. 245 - 248
• Main Authors: Gallagher, Scott F, Banasiak, Magdalena, Gonzalvo, John P, Paoli, Daniel P, Allwood, Janice, Morris, Debra, Murr, Michel M, Shapiro, David H
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.04.2003
• Subjects: Costs and Cost Analysis; Female; Gastric Bypass - economics; Gastrointestinal surgery; Health care expenditures; Health Care Rationing - economics; Health Expenditures; Hospitalization - economics; Hospitals; Humans; Male; Middle Aged; Obesity; Obesity, Morbid - surgery; Resource Allocation; United States; United States Department of Veterans Affairs - economics; United States
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1381/096089203764467144

The economic burden of caring for veterans with clinically severe obesity and its comorbidities is straining the Veterans Administration (VA) healthcare system. The authors determined the cost of Roux-en-Y Gastric Bypass (RYGBP) in the VA's single-payor healthcare system. The records of all 25 patients who underwent RYGBP from May 1999 to October 2001 were reviewed. All obesity-related health-care costs including hospitalizations as well as outpatient visits, medications and home health devices were calculated for 12 months before and after the RYGBP. Age was 52+/-2 yr and preoperative BMI was 52+/-2 kg/m(2); ASA score was III (21 patients) and II (4 patients). Mean follow-up was 18 months. Total cost of care for these patients preoperatively was $10,778+/-2,460/patient (outpatient visits=$5,476+/-682, hospital admissions=$12,221+/-6,062, and home health devices=$1,383+/-349). Postoperative length of stay was 8+/-0.5 days. Cost of the gastric bypass was $8,976+/-497/pt (OR fixed cost=$1,900/patient + ICU and ward=$7,076+/-497/patient). For the first postoperative year, 6 patients had 12 admissions, but routine outpatient visits were significantly reduced from 55+/-6 to 18+/-2 postoperatively (P<0.001). The cost of all care excluding peri-operative charges for 1 year after gastric bypass was $2,840+/-622/patient (P=0.005 vs preop). Operative treatment of clinically severe obesity reduces obesity-related expenditures and utilization of healthcare resources. The cost of undertaking RYGBP at the VA is offset by reduction of health-care costs within the first year after surgery. These data support allocation of resources to support existing bariatric surgery programs throughout the VA system.