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

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.