Uniting Health Care Perspectives through Integration of Clinical and Claims Data: An Example of Bariatric Surgery Market

OBJECTIVES: To gain insights into the healthcare utilization, costs, and clinical outcomes of patients undergoing bariatric surgery in the US.

METHODS: A retrospective study using Optum® de-identified Market Clarity Dataset (linked claims and electronic health records or EHR of patients) was done among adult (>=18 years) patients with at least 1 medical code for bariatric surgery from 1^st Jan 2016 to 31^st Dec 2016. Index date was defined as the first claim or EHR with bariatric surgery code. Only patients with >=1 ICD-10 diagnosis code for obesity in claims or EHR and no code for bariatric surgery during preceding 6 months from index date were included. All patients were followed-up for 60 months from the index date to determine their healthcare utilization, costs, and clinical outcomes after bariatric surgery. Healthcare utilization rates to be examined include average number of healthcare interactions, inpatient hospitalizations, prescriptions for anti-obesity drugs, and repeat bariatric surgery. Clinical outcomes to be evaluated include changes in body mass index (BMI) and relevant comorbidities (hypertensive disease, type 2 diabetes mellitus (T2DM), sleep apnea, ischemic heart disease, and dyslipidemia).

RESULTS: Total 26,859 patients that underwent bariatric surgery were included in the study. Almost 88% continued to have high BMI (16% had BMI 25-29.9, 72% had BMI >=30) even after bariatric surgery. Of the 53% (n=14,321) patients that had relevant comorbidities in 6 months pre-index period, less than 50% had an improvement in their comorbidity profile by the 5th year after bariatric surgery. We are currently building a model to compare ‘successful’ vs ‘failed’ patients to understand what demographic, behavioral, and clinical factors drive variability in clinical outcomes following bariatric surgery.

CONCLUSIONS: Not all patients undergoing bariatric surgery experience optimal clinical outcomes. By predicting the potential impact of bariatric surgery in patients, patients and providers can make informed healthcare choices.