Nederlandse Obesitas Kliniek, Huis ter Heide, the Netherlands; Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands.
Department of Surgery, OLVG West, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands.
J Plast Reconstr Aesthet Surg. 2020 Jun;73(6):1159-1165. doi: 10.1016/j.bjps.2020.02.002. Epub 2020 Feb 13.
Reimbursement of body-contouring surgery (BCS) is a worldwide problem: there is no objective instrument to decide which postbariatric patients should qualify for reimbursement. The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) has developed a screening tool for this purpose. In this study, we used a modified version of this screening tool in a postbariatric population and describe which patients would qualify for reimbursement using this tool.
In this cross-sectional study postbariatric patients were asked to fill in an online questionnaire based on the BAPRAS screening tool with questions regarding complaints of overhanging skin and medical history. Weight loss data were extracted from a prospective database. The BODY-Q was added to assess patient-reported outcomes.
Patients who wanted to undergo BCS (n = 90) had higher screening tool scores and lower BODY-Q scores compared to patients who did not want BCS (n = 24). In total, 25 patients (26%) qualified for reimbursement, these patients had higher weight loss (33.5% versus 29.2%, p = 0.008), lower BMI (27.3 kg/m versus 30.4 kg/m, p = 0.014) and more medical (4.0 versus 2.0, p = 0.004) and psychological complaints (88% versus 61%, p = 0.009). There was a significant, negative correlation between the screening tool scores and almost all BODY-Q scales.
Patients with a desire for BCS have more complaints of excess skin, which negatively impacts their well-being. With the modified BAPRAS screening tool, patients with the best weight (loss) and most medical and psychological complaints of excess skin qualified for referral and reimbursement of BCS.
身体塑形手术（BCS）的报销是一个全球性的问题：没有客观的工具来决定哪些减肥手术后的患者有资格获得报销。英国整形、重建和美容外科医师协会（BAPRAS）为此开发了一种筛选工具。在这项研究中，我们在减肥手术后的人群中使用了这种改良版的筛选工具，并描述了使用该工具哪些患者有资格获得报销。
在这项横断面研究中，我们让减肥后的患者填写一份基于 BAPRAS 筛选工具的在线问卷，其中包含有关皮肤下垂的抱怨和病史的问题。体重减轻的数据是从一个前瞻性数据库中提取的。还添加了 BODY-Q 以评估患者报告的结果。
想要接受 BCS 的患者（n=90）的筛选工具评分较高，而不想接受 BCS 的患者（n=24）的评分较低。共有 25 名患者（26%）有资格获得报销，这些患者的体重减轻更多（33.5%对 29.2%，p=0.008），BMI 更低（27.3kg/m 对 30.4kg/m，p=0.014），并且有更多的医疗（4.0 对 2.0，p=0.004）和心理抱怨（88%对 61%，p=0.009）。筛选工具评分与几乎所有 BODY-Q 量表之间存在显著的负相关。
有 BCS 意愿的患者对多余皮肤的抱怨更多，这对他们的幸福感有负面影响。使用改良的 BAPRAS 筛选工具，体重（减轻）最好、皮肤多余的医疗和心理抱怨最多的患者有资格接受 BCS 的转诊和报销。
