Health Expenditures of Patients With Diabetes After Bariatric Surgery: Comparing Gastric Bypass and Sleeve Gastrectomy

作者：Matthew L. Maciejewski, Lindsay Zepel, Valerie A. Smith, David Arterburn, Mary Kay Theis, Aileen Baecker, Caroline E. Sloan, Amy G. Clark, Ryan M. Kane, Christopher R. Daigle, Karen J. Coleman, Aniket A. Kawatkar · 发表于：Annals of Internal Medicine · 年份：2025 · DOI：10.7326/annals-24-00480 · 被引用次数：9 · 研究领域：Bariatric Surgery and Outcomes、Cardiovascular Function and Risk Factors、Enhanced Recovery After Surgery

BACKGROUND: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) differ in their effects on body weight and risk for reoperation. However, it is unclear whether long-term health expenditures differ by procedure type in patients with diabetes. OBJECTIVE: To compare health expenditures 3 years before and 5.5 years after bariatric surgery between patients with diabetes undergoing RYGB versus SG. DESIGN: Retrospective cohort study using target trial emulation principles. SETTING: Integrated health system. PATIENTS: = 3510) from 2012 to 2019. MEASUREMENTS: Total, inpatient, outpatient, and medication expenditures. RESULTS: , and average age was 50 years. Expenditures per 6-month period decreased by about 30% for both groups, from $4039.06 (95% CI, $3770.88 to $4326.31) 3 years before to $2441.13 (CI, $2151.07 to $2770.30) 5.5 years after RYGB and from $3918.37 (CI, $3658.75 to $4196.40) 3 years before to $2658.15 (CI, $2279.17 to $3100.16) 5.5 years after SG. Total expenditures after surgery did not differ between groups through 5.5 years (difference at 5.5 years, -$217.02 [CI, -$671.29 to $201.96]) except for the first 6 months, when expenditures were transiently higher in the RYGB group (difference, $564.32 [CI, $232.60 to $895.20]), driven by a higher inpatient admission rate. Otherwise, postsurgical outpatient and medication expenditures did not appear to differ between RYGB and SG. LIMITATION: Unobserved confounding. CONCLUSION: Overall expenditures decreased substanti...