Qing Xia, Julie A Campbell, Alex Kitsos, Petr Otahal, Michelle Kilpatrick, Alison Venn, David Preen, Barbara de Graaff, Lei Si, Amanda L Neil, Alexandr Kuzminov, Andrew J Palmer
{"title":"Economic Impact of Bariatric Surgery in Australia: 16-Year Results from the 45 and Up Study with Linked Health Data.","authors":"Qing Xia, Julie A Campbell, Alex Kitsos, Petr Otahal, Michelle Kilpatrick, Alison Venn, David Preen, Barbara de Graaff, Lei Si, Amanda L Neil, Alexandr Kuzminov, Andrew J Palmer","doi":"10.1007/s11695-024-07491-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery is the most effective long-term therapy for severe obesity; however, empirical investigation of its economic impacts has been based on limited samples, short-term costs, and a narrow range of cost categories. This study aimed to evaluate the economic impacts of bariatric surgery in a large cohort of Australians aged ≥ 45 years.</p><p><strong>Methods: </strong>N = 1157 operated (surgery) and 1157 non-operated participants were selected from the 45 and Up Study. Data sources included the baseline and follow-up surveys along with linked state and national administrative health datasets. Linear mixed-effects regression predicted the cost trajectory 8 years pre- and post-bariatric surgery, and the difference-in-differences approach evaluated its economic impact. Sensitivity analyses included an approximation of indirect costs and subgroup analysis by surgery type.</p><p><strong>Results: </strong>The matched cohort composed 77% female, had an average age of 58.1 ± 5.8 years. Direct healthcare costs increased over time in both groups. Costs for the operated group peaked ($15,884) during the surgery year and became up to 23.8% lower than those for the non-operated group from the second year post-surgery when including indirect costs. Surgery's economic benefits increased over longer horizons, with a maximum annual cost-saving of $3196 per person in the eighth post-surgery year. However, even after accounting for indirect costs, cumulative cost-savings were not achieved. Subgroup analysis revealed sleeve gastrectomy as the least costly surgical option.</p><p><strong>Conclusion: </strong>Higher short-term costs in the surgery year primarily drove inter-group cost differences. The economic value of bariatric surgery lies in the long-term benefits, particularly when considering indirect costs.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11695-024-07491-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Bariatric surgery is the most effective long-term therapy for severe obesity; however, empirical investigation of its economic impacts has been based on limited samples, short-term costs, and a narrow range of cost categories. This study aimed to evaluate the economic impacts of bariatric surgery in a large cohort of Australians aged ≥ 45 years.
Methods: N = 1157 operated (surgery) and 1157 non-operated participants were selected from the 45 and Up Study. Data sources included the baseline and follow-up surveys along with linked state and national administrative health datasets. Linear mixed-effects regression predicted the cost trajectory 8 years pre- and post-bariatric surgery, and the difference-in-differences approach evaluated its economic impact. Sensitivity analyses included an approximation of indirect costs and subgroup analysis by surgery type.
Results: The matched cohort composed 77% female, had an average age of 58.1 ± 5.8 years. Direct healthcare costs increased over time in both groups. Costs for the operated group peaked ($15,884) during the surgery year and became up to 23.8% lower than those for the non-operated group from the second year post-surgery when including indirect costs. Surgery's economic benefits increased over longer horizons, with a maximum annual cost-saving of $3196 per person in the eighth post-surgery year. However, even after accounting for indirect costs, cumulative cost-savings were not achieved. Subgroup analysis revealed sleeve gastrectomy as the least costly surgical option.
Conclusion: Higher short-term costs in the surgery year primarily drove inter-group cost differences. The economic value of bariatric surgery lies in the long-term benefits, particularly when considering indirect costs.
期刊介绍:
Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions.
Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.