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在减肥手术后的20年内使用医疗保健
Martin Neovius1, Kristina Narbro, Catherine Keating
1Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. martin.neovius@ki.se
JAMA
|September 20, 2012
概括
腹部外科手术患者最初的医疗保健使用率较高,但长期药物成本较低. 20多年来,手术最初导致了住院和门诊护理的增加,但成本平衡,后来降低了药物费用.
科学领域:
- 腹腔外科手术的结果
- 长期医疗保健利用情况
- 肥胖治疗影响肥胖治疗的影响.
背景情况:
- 减肥手术促进持续减肥,并降低糖尿病,心血管事件,癌症和死亡率的风险.
- 减肥手术对医疗保健利用的长期影响仍然在很大程度上是未知的.
- 瑞典肥胖受试者 (SOS) 研究提供了一个独特的,长期的观点,关于减肥手术的结果.
研究的目的:
- 评估和比较20年期间的肥胖患者的医疗保健利用率,这些患者接受了减肥手术治疗,与传统的肥胖管理相比.
- 评估两组之间的住院医院日数,非初级保健门诊访问和药物成本的差异.
主要方法:
- 展望性,非随机化,受控干预研究 (瑞典肥胖患者研究) 涉及2010名减肥手术患者和2037名匹配对照.
- 20年来,从瑞典国家登记处收集了有关医院住院,门诊和药物费用的数据.
- 统计分析根据基线特征进行调整,包括年龄,性别,BMI和糖尿病状况.
主要成果:
- 与对照组相比,腹外科手术患者最初的住院 (2-6年) 和非初级门诊护理利用率较高.
- 在最初的6年后,在手术和对照组之间,住院和门诊护理的利用率变得相似.
- 从7岁到20岁,减肥手术患者与对照人群相比,每年药费明显降低 (平均差异为-228美元).
结论:
- 减肥手术与初始医疗保健利用率的增加有关,但不是长期的.
- 与接受常规治疗的患者相比,接受减肥手术的患者的长期药物费用明显较低.
- 这些发现凸显了减肥手术对整体医疗保健资源利用的复杂,时间依赖的影响.
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