Healthcare utilization and costs in severely obese subjects before bariatric surgery

Catherine L Keating, Marjory Moodie, Liliana Bulfone, Boyd Anthony Swinburn, Christopher E Stevenson, Anna Peeters

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16 Citations (Scopus)


This study examined healthcare utilization and associated costs for a severely obese population before receiving bariatric surgery relative to an age-and sex-matched sample from the Australian general population. Severely obese subjects receiving laparoscopic adjustable gastric banding (LAGB) surgery in 2009 (n = 11,769) were identified. Utilization of medical services and pharmaceuticals in the 3.5 years before surgery were ascertained for each severely obese subject through linkage with Medicare, Australia s universal health insurance scheme. Equivalent data were retrieved for each subject from the matched general population sample (n = 140,000). Severely obese subjects utilized significantly more medical services annually compared to the general population (mean: 22.8 vs. 12.1/person, standardized incidence ratio (SIR): 1.89 (95 confidence interval (CI) 1.88-1.89)), translating to twofold higher mean annual costs (Australian 1,140 vs. 567/person). The greatest excess costs in the obese related to consultations with general practitioners, psychiatrists/psychologists and other specialists, investigations for obstructive sleep apnea, and in vitro fertilization. Severely obese subjects also utilized significantly more pharmaceutical prescriptions annually (mean: 11.4 vs. 5.3/person, SIR 2.18 (95 CI: 2.17-2.19)), translating to 2.2-fold higher mean annual costs ( 595/person vs. 270/person). The greatest excess costs in the obese related to diabetes drugs, lipid-modifying agents, psychoanaleptics, acid-related disorder drugs, agents acting on the rennin-angiotensin system, immunosuppressants, and obstructive airway disease drugs. Overall, healthcare costs in the severely obese population were more than double those incurred by the general population.
Original languageEnglish
Pages (from-to)2412 - 2418
Number of pages7
Issue number12
Publication statusPublished - 2012

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