John Cawley1, Timothy Prinz, Susan Beane. 1. Department of Policy Analysis and Management and Sloan Program in Health Administration, Cornell University, Ithaca, NY 14853, USA. jhc38@cornell.edu
Abstract
BACKGROUND: We measured the very short-term change in obesity-related co-morbidities following bariatric surgery. METHODS: Claims data were analyzed for 933 patients aged 18-62 who were covered by one of 11 New York State health plans and underwent bariatric surgery during calendar year 2002. Data covered 6 months before to 6 months after surgery. Logit regression and fixed effects logit regressions were estimated, to analyze change in the following co-morbidities after bariatric surgery: diabetes, hyperlipidemia, hypertension, asthma, sleep apnea, degenerative joint disease, gastroesophageal reflux, and depression. RESULTS: There were statistically significant post-surgery decreases in each outcome studied. Controlling for individual fixed effects, the probability of a diabetes diagnosis fell by 20% after bariatric surgery. The probability of sleep apnea fell by 33%, and the probability of the other obesity-related co-morbidities fell by 11 to 19% at 6 months. CONCLUSION: Claims data are useful for assessing changes in a wide range of co-morbidities following bariatric surgery. The data indicate significant decreases in obesity-related co-morbidities after bariatric surgery, although considerably smaller than those found in previous studies, which underscores the need for randomized controlled trials of bariatric surgery. Limitations of this study include: follow-up only at 6 months, non-experimental data, and an unknown degree of under-reporting of co-morbidities in claims data.
BACKGROUND: We measured the very short-term change in obesity-related co-morbidities following bariatric surgery. METHODS: Claims data were analyzed for 933 patients aged 18-62 who were covered by one of 11 New York State health plans and underwent bariatric surgery during calendar year 2002. Data covered 6 months before to 6 months after surgery. Logit regression and fixed effects logit regressions were estimated, to analyze change in the following co-morbidities after bariatric surgery: diabetes, hyperlipidemia, hypertension, asthma, sleep apnea, degenerative joint disease, gastroesophageal reflux, and depression. RESULTS: There were statistically significant post-surgery decreases in each outcome studied. Controlling for individual fixed effects, the probability of a diabetes diagnosis fell by 20% after bariatric surgery. The probability of sleep apnea fell by 33%, and the probability of the other obesity-related co-morbidities fell by 11 to 19% at 6 months. CONCLUSION: Claims data are useful for assessing changes in a wide range of co-morbidities following bariatric surgery. The data indicate significant decreases in obesity-related co-morbidities after bariatric surgery, although considerably smaller than those found in previous studies, which underscores the need for randomized controlled trials of bariatric surgery. Limitations of this study include: follow-up only at 6 months, non-experimental data, and an unknown degree of under-reporting of co-morbidities in claims data.
Authors: Carlos Augusto Scussel Madalosso; Fernando Fornari; Sidia M Callegari-Jacques; Carlos Antônio Madalosso; Richard Ricachenevsky Gurski Journal: Obes Surg Date: 2008-03-06 Impact factor: 4.129