Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany.
German Center for Diabetes Research, Neuherberg, Germany.
Health Econ. 2019 Nov;28(11):1293-1307. doi: 10.1002/hec.3941. Epub 2019 Sep 5.
Surgical measures to combat obesity are very effective in terms of weight loss, recovery from diabetes, and improvement in cardiovascular risk factors. However, previous studies found both positive and negative results regarding the effect of bariatric surgery on health care utilization. Using claims data from the largest health insurance provider in Germany, we estimated the causal effect of bariatric surgery on health care costs in a time period ranging from 2 years before to 3 years after bariatric intervention. Owing to the absence of a control group, we employed a Bayesian structural forecasting model to construct a synthetic control. We observed a decrease in medication and physician expenditures after bariatric surgery, whereas hospital expenditures increased in the post-intervention period. Overall, we found a slight increase in total costs after bariatric surgery, but our estimates include a high degree of uncertainty.
手术减肥在减轻体重、糖尿病康复和改善心血管风险因素方面非常有效。然而，先前的研究发现减重手术对医疗保健利用的影响既有积极的结果，也有消极的结果。利用德国最大的健康保险公司的索赔数据，我们在 2 年的术前到 3 年的术后时间段内估计了减重手术对医疗费用的因果效应。由于缺乏对照组，我们采用贝叶斯结构预测模型来构建一个综合对照。我们观察到减重手术后药物和医生支出减少，而术后住院支出增加。总的来说，我们发现减重手术后总费用略有增加，但我们的估计存在高度不确定性。
