Larsen Arendse Tange, Højgaard Betina, Ibsen Rikke, Kjellberg Jakob
University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark.
Danish Institute for Local and Regional Government Research, KORA, Købmagergade 22, 1150, Copenhagen, Denmark.
Obes Surg. 2018 Feb;28(2):338-348. doi: 10.1007/s11695-017-2834-z.
A recurring argument for bariatric surgery is cost savings due to sustained weight loss and reductions in comorbidities. However, studies prompting this argument tend to focus only on health care costs, and in some of them, cost changes after surgery have been modelled. The aim of this study was to generate real-world evidence on the socio-economic impact of bariatric surgery, by evaluating the effect on both direct and indirect costs.
Using real-world data from national registries, predictions of health care costs, social transfer payments and income were performed for a surgically treated individual and compared to those for a similar but non-surgically treated individual 3 years before and after surgery. Secondly, the relative risks for health care costs, social transfer payments and income of a surgical group compared with a non-surgical group were estimated. The non-surgical group was defined as being eligible for bariatric surgery but not undergoing it.
Bariatric surgery was associated with higher, but insignificantly so, health care costs, primarily due to an increase in somatic inpatient services. A significant decrease in costs of drugs was seen, especially for anti-diabetic medication. Bariatric surgery had a slight positive effect on social transfer payments and no significant effect on income.
There are no cost savings of bariatric surgery in the short run. Further real-world evidence over a longer period of time is needed to examine whether the higher health care costs will eventually be counterbalanced, making bariatric surgery a profitable intervention in a socio-economic perspective.
减肥手术反复被提及的一个理由是，由于体重持续减轻和合并症减少，可节省成本。然而，支持这一观点的研究往往只关注医疗保健成本，其中一些研究还对手术后的成本变化进行了建模。本研究的目的是通过评估减肥手术对直接成本和间接成本的影响，得出关于减肥手术社会经济影响的实际证据。
利用国家登记处的实际数据，对一名接受手术治疗的个体的医疗保健成本、社会转移支付和收入进行预测，并与手术前和手术后3年的类似但未接受手术治疗的个体进行比较。其次，估计手术组与非手术组在医疗保健成本、社会转移支付和收入方面的相对风险。非手术组定义为符合减肥手术条件但未接受手术的人群。
减肥手术与更高的医疗保健成本相关，但不显著，主要是由于躯体住院服务增加。药物成本显著下降，尤其是抗糖尿病药物。减肥手术对社会转移支付有轻微的积极影响，对收入没有显著影响。
减肥手术短期内不会节省成本。需要更长时间的进一步实际证据来研究更高的医疗保健成本最终是否会被抵消，从而使减肥手术从社会经济角度来看成为一项有利可图的干预措施。
