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Does bariatric surgery reduce future hospital costs? a propensity score-matched analysis using UK Biobank Study data

Abstract:

Objectives: To estimate the hospital costs among persons with obesity undergoing bariatric surgery compared with those without bariatric surgery.

Methods: We analysed the UK Biobank Cohort study linked to Hospital Episode Statistics, for all adults with obesity undergoing bariatric surgery at National Health Service hospitals in England, Scotland, or Wales from 2006 to 2017. Surgery patients were matched with controls who did not have bariatric surgery using propensity scores approach with a ratio of up to 1-to-5 by year. Inverse probability of censoring weighting was used to correct for potential informative censoring. Annual and cumulative hospital costs were assessed for the surgery and control groups.

Results: We identified 348 surgical patients (198 gastric bypass, 73 sleeve gastrectomy, 77 gastric banding) during the study period. In total, 324 surgical patients and 1506 matched control participants were included after propensity score matching. Mean 5-year cumulative hospital costs were €11,659 for 348 surgical patients. Compared with controls, surgical patients (n = 324) had significantly higher inpatient expenditures in the surgery year (€7289 vs. €2635, P < 0.001), but lower costs in the subsequent 4 years. The 5-year cumulative costs were €11,176 for surgical patients and €8759 for controls (P = 0.001).

Conclusions: Bariatric surgery significantly increased the inpatient costs in the surgery year, but was associated with decreased costs in the subsequent 4 years. However, any cost savings made up to 4 years were not enough to compensate for the initial surgical expenditure.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1038/s41366-021-00887-2

Authors

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Role:
Author
ORCID:
0000-0003-3609-5016
More by this author
Institution:
University of Oxford
Division:
MSD
Sub department:
Population Health
Role:
Author
ORCID:
0000-0001-7097-8950
More by this author
Institution:
University of Oxford
Division:
MSD
Sub department:
Population Health
Role:
Author
ORCID:
0000-0002-2361-3040


Publisher:
Springer Nature
Journal:
International Journal of Obesity More from this journal
Volume:
45
Issue:
10
Pages:
2205-2213
Place of publication:
England
Publication date:
2021-07-01
Acceptance date:
2021-06-22
DOI:
EISSN:
1476-5497
ISSN:
0307-0565
Pmid:
34211116


Language:
English
Keywords:
Pubs id:
1184928
Local pid:
pubs:1184928
Deposit date:
2021-10-06
ARK identifier:

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