National Trends in Bariatric Surgery 2012–2015: Demographics, Procedure Selection, Readmissions, and Cost

May 24, 2017Obesity surgery

National Trends in Weight Loss Surgery from 2012 to 2015: Patient Characteristics, Surgery Types, Hospital Readmissions, and Costs

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Abstract

The proportion of sleeve gastrectomy (SG) procedures increased from 38% to 63% between 2012 and 2015.

Roux-en-Y gastric bypass (RYGB) procedures decreased from 44% to 30% during the same period.
Use of adjustable gastric banding (LAGB) declined significantly, from 13% to 2%.
SG is associated with a lower likelihood of readmission compared to RYGB, with an odds ratio of 0.64.
The percentage of patients seeking RYGB with type 2 diabetes was higher than for SG (36% vs. 25%).
SG has become the most common bariatric procedure among diabetics, surpassing RYGB.
SG is less expensive than RYGB, with average costs of $11,183 compared to $13,485.

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BACKGROUND: Bariatric surgery is widely accepted as the best treatment for obesity and type 2 diabetes mellitus (T2DM). The Roux-en-Y gastric bypass (RYGB) and the sleeve gastrectomy (SG) have become the predominant bariatric procedures in the USA over the last several years, although the most recent trends in selection are unknown.

OBJECTIVE: The objective of this study is to assess selection trends, readmission rates, and cost of bariatric procedures in the USA from 2012 to 2015.

METHODS: We used the Premier database from 2012 to 2015 to examine trends in incidence of RYGB, adjustable gastric banding (LAGB), and SG; readmissions; and cost. Multivariate regression was performed to identify predictors of readmission.

RESULTS: The proportion of SG went up from 38 to 63% while the RYGB decreased from 44 to 30% over this time period. LAGB has decreased in use from 13 to 2%. In comparison to RYGB, readmission was less likely for SG (OR 0.64), males (OR 0.91), and more likely for black race (OR 1.27). The overall proportion of patients seeking RYGB with type 2 diabetes was higher than with SG (36 versus 25%), but SG has now overtaken RYGB as the most common procedure among diabetics. The SG is less costly than RYGB ($11,183 versus $13,485).

CONCLUSIONS: There is a continued overall trend in the increased popularity of the SG and decreased utilization of the RYGB and LAGB, although growth of the SG appears to be slowing. This is also true among patients with type 2 diabetes mellitus. Regardless of surgery type, underinsured and African-American race were more likely to be readmitted.

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National Trends in Bariatric Surgery 2012–2015: Demographics, Procedure Selection, Readmissions, and Cost

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