Universität zu Köln

Broderick, Ryan C., Fuchs, Hans F., Harnsberger, Cristina R., Chang, David C., Sandler, Bryan J., Jacobsen, Garth R. and Horgan, Santiago (2015). Increasing the Value of Healthcare: Improving Mortality While Reducing Cost in Bariatric Surgery. Obes. Surg., 25 (12). S. 2231 - 2239. NEW YORK: SPRINGER. ISSN 1708-0428

Full text not available from this repository.

Abstract

Healthcare costs in the United States (U.S.) are rising. As outcomes improve, such as decreased length of stay and decreased mortality, it is expected that costs should go down. The aim of this study is to analyze hospital charges, cost of care, and mortality in bariatric surgery over time. A retrospective analysis of the Nationwide Inpatient Sample (NIS) database was performed. Adults with morbid obesity who underwent gastric bypass or sleeve gastrectomy were identified by ICD-9 codes. Multivariate analyses identified independent predictors of changes in hospital charges and in-hospital mortality. Results were adjusted for age, race, gender, Charlson comorbidity index, surgical approach (open versus laparoscopic), hospital volume, and insurance status. In order to estimate baseline surgical inflation, changes in hospital charges over time were also calculated for appendectomy. From 1998 to 2011, 209,106 patients were identified who underwent bariatric surgery. Adjusted in-hospital mortality for bariatric surgery decreased significantly by 2003 compared to 1998 (p < 0.001, OR 0.47, 95 % CI 0.22-0.92) and remained significantly decreased for the remainder of the study period. As such, a 60-80 % decrease in mortality was maintained from 2003 to 2010 compared to 1998. After adjusting for inflation, the cumulative increase in hospital charges per day of a bariatric surgery admission was 130 % from 1998 to 2011. Charges per stay increased by 2.1 % annually for bariatric surgery compared to 5.5 % for appendectomy. In-hospital mortality rate following bariatric surgery underwent a ninefold decrease since 1998 while maintaining surgical inflation costs less than appendectomy. Innovation in bariatric surgical technique and technology has resulted in improvement of outcomes while providing overall cost savings.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Broderick, Ryan C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Hans F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Harnsberger, Cristina R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chang, David C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sandler, Bryan J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jacobsen, Garth R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horgan, Santiago UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-385659
DOI:	10.1007/s11695-015-1710-y
Journal or Publication Title:	Obes. Surg.
Volume:	25
Number:	12
Page Range:	S. 2231 - 2239
Date:	2015
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1708-0428
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE APPENDICITIS; UNITED-STATES; OUTCOMES; OBESITY; POPULATION; MANAGEMENT; TRENDS; IMPACT; BYPASS; VOLUME Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38565