Impact of Bariatric Surgery on Health Care Costs of Obese Persons: A 6-Year Follow-up of Surgical and Comparison Cohorts Using Health Plan Data
Jonathan P. Weiner, DrPH; Suzanne M. Goodwin, PhD; Hsien-Yen Chang, PhD, MHS; Shari D. Bolen, MD, MPH; Thomas M. Richards, MSEE; Roger A. Johns, MD, MHS; Soyal R. Momin, MS, MBA; Jeanne M. Clark, MD, MPH
Importance Bariatric surgery is a well-documented treatment for obesity, but there are uncertainties about the degree to which such surgery is associated with health care cost reductions that are sustained over time.
Objective To provide a comprehensive, multiyear analysis of health care costs by type of procedure within a large cohort of privately insured persons who underwent bariatric surgery compared with a matched nonsurgical cohort.
Design Longitudinal analysis of 2002-2008 claims data comparing a bariatric surgery cohort with a matched nonsurgical cohort.
Setting Seven BlueCross BlueShield health insurance plans with a total enrollment of more than 18 million persons.
Participants A total of 29 820 plan members who underwent bariatric surgery between January 1, 2002, and December 31, 2008, and a 1:1 matched comparison group of persons not undergoing surgery but with diagnoses closely associated with obesity.
Main Outcome Measures Standardized costs (overall and by type of care) and adjusted ratios of the surgical group’s costs relative to those of the comparison group.
Results Total costs were greater in the bariatric surgery group during the second and third years following surgery but were similar in the later years. However, the bariatric group’s prescription and office visit costs were lower and their inpatient costs were higher. Those undergoing laparoscopic surgery had lower costs in the first few years after surgery, but these differences did not persist.
Conclusions and Relevance Bariatric surgery does not reduce overall health care costs in the long term. Also, there is no evidence that any one type of surgery is more likely to reduce long-term health care costs. To assess the value of bariatric surgery, future studies should focus on the potential benefit of improved health and well-being of persons undergoing the procedure rather than on cost savings.
JAMA Surg. 2013;148(6):555-562.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.