Bariatric surgery: time to move beyond clinical outcomes

Abstract

In a well-designed analysis of the long-term health-care costs of patients in the Swedish Obese Subjects (SOS) study, Catherine Keating and colleagues 1 Keating C Neovius M Sjöholm K Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the Swedish Obese Subjects study. Lancet Diabetes Endocrinol. 2015; (published online Sept 17.)http://dx.doi.org/10.1016/S2213-8587(15)00290-9 Google Scholar show that use of health resources and expenditure after bariatric surgery is related to baseline glucose status. This finding lends support to the notion that this expenditure is therefore not related to BMI or the amount of postoperative weight loss. In patients with obesity and either euglycaemia or prediabetes at baseline, total health-care costs after up to 15 years follow-up were greater in patients who underwent bariatric surgery than in those treated conventionally. By contrast, in patients with type 2 diabetes at baseline, there was no difference in health-care costs between those treated with surgery versus conventional approaches; in this subgroup, the costs of surgery were offset mainly by lower use of health care and prescription drugs during follow-up. Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the Swedish Obese Subjects studyTotal health-care costs were higher for patients with euglycaemia or prediabetes in the surgery group than in the conventional treatment group, but we detected no difference between the surgery and conventional treatment groups for patients with diabetes. Long-term health-care cost results support prioritisation of patients with obesity and type 2 diabetes for bariatric surgery. Full-Text PDF