Bariatric treatments for adult obesity - Institute of Health Economics

Definition of bariatric surgical patientsTable E.1 outlines the CCI codes that correspond to a specific type of bariatric surgery. Patientswere included in the analysis if they had any one of these codes listed in the principal interventionfield in the DAD.Table E.1: CCI code description for bariatric surgeriesOpen approachLaparoscopicapproachDescription1.NF.78.XP 1.NF.78.EJ Using vertical banded technique1.NF.78.WJ 1.NF.78.GB Using vertical (sleeve) gastrectomy technique1.NF.78.SH 1.NF.78.DQ Using gastric bypass technique with gastroenterostomy (e.g., Roux-en-Y)1.NF.78.SJ1.NF.78.SI1.NF.78.DO1.NF.78.DIUsing gastric bypass technique with gastroenterostomy and biliopancreaticbypass [to terminal ileum] (e.g., biliopancreatic diversion)Using gastric bypass technique with enteroenterostomy and biliopancreaticbypass [to terminal ileum] (e.g., duodenal switch)Secondary analysis of Provincial Health Utilization databases and CCHS dataSource of informationInformation on health service utilization was retrieved from the three provincial health utilizationdatabases identified above. Health utilization data from 2007 was linked with epidemiologic (BMI),demographic (age, gender, income, and education), behavioural (smoking status and physicalactivity), and health status (presence of diabetes, hypertension, COPD, and back problems) datacontained in the 2007 CCHS.AnalysisSix separate multivariate regression models were developed to estimate the impact of BMI onphysician visits, physician costs, outpatient visits, outpatient costs, combined physician andoutpatient costs, and inpatient admissions. Note that inpatient costs were unavailable in the dataset.BMI was divided into four categories characterizing underweight, normal weight, overweight, andobese (as defined in the S section of this report). Furthermore, each model was adjusted for age,gender, income, education, smoking status, physical activity, and the presence of diabetes,hypertension, COPD, and back problems. All analyses were conducted with STATA 9.1 (StatacorpLP, College Station, Texas). Statistical significance was defined at p < 0.05.Calculation of health service utilization and costsAdjusted estimates of mean physician visits, outpatient visits, and inpatient admissions in 2007 byBMI category were estimated from the regression models. Using normal weight as a point ofreference, differences in adjusted mean costs and visits were calculated for underweight, overweightand obesity. Total economic burden was then calculated by multiplying the incremental adjustedmean difference with the prevalence of Albertans who are underweight, overweight, or obese (referto Appendix E.B for complete details).Bariatric treatments for adult obesity 162