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Comparison of Non-routine Healthcare Utilization in the 2 years Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy: A Cohort Study

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Abstract

Background

Patients undergoing Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have different healthcare needs after surgery. Our aim was to quantify non-routine healthcare utilization after RYGB vs. SG.

Methods

We compared non-routine (NR) visits made and associated services provided up to 2 years post-surgery for patients undergoing RYGB or SG at a Bariatric Surgery Comprehensive Center between March 2013 and April 2015.

Results

A total of 258 and 461 patients had primary RYGB and SG, respectively. Successful follow-up rates at one (76.2%) and 2 years post-surgery (52.6%) did not differ between groups. Rates for all NR visits, expressed as the number per 100 patients, were 68.6 in RYGB vs. 35.4 in SG patients (p < 0.0001). Emergency department visits with subsequent admission (EDA) or without subsequent admission (ED-only) and outpatient visits (OPV) were more frequent in RYGB vs. SG: EDA, 14.7 vs. 8.0 (p = 0.0076); ED-only, 17.8 vs. 7.6 (p = 0.0001); and OPV, 29.8 vs. 14.1 (p < 0.0001). RYGB required more services per 100 patients than SG, 120.9 vs. 75.3, respectively (p < 0.0001). Imaging was the resource most often used overall. Surgery type (RYGB) significantly predicted healthcare utilization even after controlling for gender, ethnicity, and other variables. Healthcare utilization peaked at 1 to 6 months post-surgery, driven by patients who underwent RYGB.

Conclusions

RYGB required twice as many non-routine follow-up visits and 1.6 times greater use of healthcare services relative to SG. Computer-assisted tomography imaging and endoscopies showed the greatest differences. Peak healthcare utilization for RYGB occurred between 1 and 6 months following surgery.

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Authors and Affiliations

  1. Hartford Healthcare Surgical Weight Loss Center, Hartford, CT, 06102, USA

    Richard L. Seip, Kyle Robey, Andrea Stone, Geneth Chin, Tara McLaughlin, Darren Tishler & Pavlos Papasavas

  2. Hartford Hospital Research Program, Hartford, CT, 06102, USA

    Ilene Staff

  3. Department of Surgery, Hartford Healthcare Medical Group, 85 Seymour Street, Hartford, CT, 06106, USA

    Tara McLaughlin

Authors
  1. Richard L. Seip
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  2. Kyle Robey
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  3. Andrea Stone
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  4. Geneth Chin
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  5. Ilene Staff
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  6. Tara McLaughlin
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  7. Darren Tishler
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  8. Pavlos Papasavas
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Corresponding author

Correspondence to Tara McLaughlin.

Ethics declarations

The study site is accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). The study was approved by the local Institutional Review Board.

Conflict of Interest

DT served as a consultant for Olympus and Medtronic. PP served as a consultant for Olympus.

Statement of Informed Consent

This study was approved by the Hartford Hospital Institutional Review Board (HHC-2017-0077) with a waiver of informed consent.

Ethical Approval

This study was approved by the Hartford Hospital Institutional Review Board (HHC-2017-0077). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Seip, R.L., Robey, K., Stone, A. et al. Comparison of Non-routine Healthcare Utilization in the 2 years Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy: A Cohort Study. OBES SURG 29, 1922–1931 (2019). https://doi.org/10.1007/s11695-019-03793-9

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  • DOI: https://doi.org/10.1007/s11695-019-03793-9

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