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Roux-en-Y 胃旁路术后充分补充多种维生素可降低国家医疗保健成本:成本效益分析。

Adequate Multivitamin Supplementation after Roux-En-Y Gastric Bypass Results in a Decrease of National Health Care Costs: a Cost-Effectiveness Analysis.

机构信息

Department of Surgery, Rijnstate Hospital, Postal number 1190, 6800 TA, Arnhem, The Netherlands.

出版信息

Obes Surg. 2019 May;29(5):1638-1643. doi: 10.1007/s11695-019-03750-6.

DOI:10.1007/s11695-019-03750-6
PMID:30725428
Abstract

INTRODUCTION

Patients with morbid obesity undergoing metabolic surgery are prone to develop vitamin and mineral deficiencies, which may worsen in time. In order to prevent these deficiencies after metabolic surgery, all patients are advised to take daily multivitamin supplementation. The aim of the study was to assess the cost-effectiveness of specially developed multivitamins (WLS Forte®) for metabolic surgery and over-the-counter (standard) multivitamin supplementation (sMVS).

METHODS

This cost-effectiveness analysis was preformed alongside an RCT for the Netherlands. Between June 2011 and March 2012, a total of 148 patients were randomized to one tablet daily of either WLS Forte® or sMVS. The patients were followed for 12 months. Data on costs within the health sector and outside the health sector were collected. The primary outcome is financial and logistic advantages, in terms of less patient visits to the outpatient department and the relevant costs to the employer due to absenteeism.

RESULTS

In total, 10 (14%) patients in the WLS Forte® group versus 23 (30%) patients in the sMVS group developed a deficiency. The costs for the WLS forte® supplement were €38 versus €23 for sMVS. Additional return visits and associated costs for medical staff were the largest costs, up to 43% in the sMVS group. Total costs for supplementation with sMVS were €243 versus €134 for WLS Forte®.

CONCLUSION

Preventing deficiencies with WLS Forte® seem initially more expensive than sMVS. However, treatment with WLS Forte® resulted in less vitamin and mineral deficiencies, which eventually resulted in less overall costs.

摘要

简介

接受代谢手术的病态肥胖患者容易出现维生素和矿物质缺乏症,且随着时间的推移可能会恶化。为了预防代谢手术后出现这些缺乏症,建议所有患者每天服用多种维生素补充剂。本研究旨在评估专为代谢手术开发的多种维生素(WLS Forte®)与非处方(标准)多种维生素补充剂(sMVS)的成本效益。

方法

本成本效益分析是在荷兰的一项 RCT 基础上进行的。2011 年 6 月至 2012 年 3 月期间,共有 148 名患者被随机分配至每天服用一片 WLS Forte®或 sMVS。对患者进行了 12 个月的随访。收集了卫生部门内和卫生部门外的成本数据。主要结局是财务和后勤优势,具体表现为患者就诊次数减少,因旷工导致雇主相关成本减少。

结果

WLS Forte®组共有 10 名(14%)患者发生缺乏症,sMVS 组有 23 名(30%)患者发生缺乏症。WLS forte®补充剂的成本为 38 欧元,sMVS 的成本为 23 欧元。额外的复诊次数和相关医疗人员费用是最大的成本,在 sMVS 组中占比高达 43%。sMVS 组的补充总成本为 243 欧元,WLS Forte®组为 134 欧元。

结论

使用 WLS Forte®预防缺乏症的初始成本似乎高于 sMVS,但使用 WLS Forte®治疗可减少维生素和矿物质缺乏症,从而最终降低整体成本。

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本文引用的文献

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IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures.国际肥胖与代谢病外科联盟2016年全球调查:原发性、腔内及修复性手术
Obes Surg. 2018 Dec;28(12):3783-3794. doi: 10.1007/s11695-018-3450-2.
2
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Medicine (Baltimore). 2014 Nov;93(25):e169. doi: 10.1097/MD.0000000000000169.
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Prevalence of Anemia and Related Deficiencies in the First Year following Laparoscopic Gastric Bypass for Morbid Obesity.
J Nutr Sci. 2020 Oct 8;9:e46. doi: 10.1017/jns.2020.41. eCollection 2020.
病态肥胖患者腹腔镜胃旁路术后第一年贫血及相关缺乏症的患病率
J Obes. 2012;2012:193705. doi: 10.1155/2012/193705. Epub 2012 Mar 13.
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Calcium and vitamin D supplementation after gastric bypass should be individualized to improve or avoid hyperparathyroidism.胃旁路术后应个体化补充钙和维生素 D,以改善或避免甲状旁腺功能亢进。
Obes Surg. 2010 Jun;20(6):738-43. doi: 10.1007/s11695-010-0138-7.
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Calcium intake and metabolic bone disease after eight years of Roux-en-Y gastric bypass.Roux-en-Y胃旁路术后八年的钙摄入量与代谢性骨病
Obes Surg. 2008 Apr;18(4):386-90. doi: 10.1007/s11695-007-9393-7. Epub 2008 Jan 31.
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Nutritional deficiencies following bariatric surgery: what have we learned?减重手术后的营养缺乏:我们学到了什么?
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