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Hospital costs associated with bariatric procedures in the United States.

Livingston EH

Department of Surgery, VAMC, Dallas and the Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern School of Medicine, 5323 Harry Hines Blvd., Room E7-126, Dallas, TX 75390-9156, USA.

BACKGROUND: Weight loss operations are being performed at an exponentially increasing rate. Although highly effective for controlling obesity and its complications, the operations are expensive. The operations are thought to be cost-effective, but there has not been an analysis of the costs associated with these procedures at a national level precluding definitive cost-effectiveness studies useful for policy determination. METHODS: The 2001 and 2002 National Inpatient Survey (NIS) was used to establish costs attributable to bariatric surgery. This survey contains discharge information for approximately 20% of all US hospital admissions in any given year. Bariatric procedures were identified by ICD-9-CM procedures codes and diagnostic related group (DRG) 288 (operating room [OR] procedures for obesity). RESULTS: Of the commonly performed operations, laparoscopic gastric bypass had the lowest hospital charges (19,794 dollars/case) relative to open gastric bypass (22,313 dollars/case) and laparoscopic banding procedures (25,355 dollars/case). Laparoscopic gastric bypass resulted in fewer charges because of a 1-day shorter median length of stay. DISCUSSION: These data provide benchmarks for the costs associated with the weight loss procedures commonly performed in the United States. Although laparoscopic gastric bypass is the lease costly approach to bariatric surgery, the fact that costs are lower because of decreased length of stay can be disadvantageous for hospitals reimbursed on a per diem basis.

Published 17 October 2005 in Am J Surg, 190(5): 816-20.
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