• Matthew L Maciejewski, Edward H Livingston, Valerie A Smith, Leila C Kahwati, William G Henderson, and David E Arterburn.
• Center for Health Services Research in Primary Care, Durham Veterans Affairs, Durham, NC 27705, USA. matthew.maciejewski@va.gov
• Arch Surg. 2012 Jul 1;147(7):633-40.

ObjectiveTo determine whether bariatric surgery is associated with reduced health care expenditures in a multisite cohort of predominantly older male patients with a substantial disease burden.DesignRetrospective cohort study of bariatric surgery. Outpatient, inpatient, and overall health care expenditures within Department of Veterans Affairs (VA) medical centers were examined via generalized estimating equations in the propensity-matched cohorts.SettingBariatric surgery programs in VA medical centers.ParticipantsEight hundred forty-seven veterans who were propensity matched to 847 nonsurgical control subjects from the same 12 VA medical centers.InterventionBariatric surgical procedures.Main Outcome MeasureHealth expenditures through December 2006.ResultsOutpatient, inpatient, and total expenditures trended higher for bariatric surgical cases in the 3 years leading up to the procedure and then converged back to the lower expenditure levels of nonsurgical controls in the 3 years after the procedure.ConclusionsBased on analyses of a cohort of predominantly older men, bariatric surgery does not appear to be associated with reduced health care expenditures 3 years after the procedure.

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