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Budget impact analysis of surgical treatment for obesity in sweden.

Borg, Sixten LU ; Näslund, I; Persson, Ulf LU and Odegaard, K (2012) In Scandinavian Journal of Surgery 101(3). p.190-197
Abstract
Background:

The recent substantial increase in the number of obese surgeries performed in Sweden has raised concerns about the budget impact.



Objective: Our aim in this paper is to present an assessment of the budgetary impact of different policies for surgical intervention for obese and overweight subjects from a healthcare perspective in Sweden.



Methods: The model simulates the annual expected treatment costs of obesity related diseases and surgery in patients of different sex, age and Body Mass Index (BMI). Costs evaluated are costs of surgery plus the excess treatment costs that an obese patient has over and above the treatment costs of a normal-weight patient. The diagnoses that are... (More)
Background:

The recent substantial increase in the number of obese surgeries performed in Sweden has raised concerns about the budget impact.



Objective: Our aim in this paper is to present an assessment of the budgetary impact of different policies for surgical intervention for obese and overweight subjects from a healthcare perspective in Sweden.



Methods: The model simulates the annual expected treatment costs of obesity related diseases and surgery in patients of different sex, age and Body Mass Index (BMI). Costs evaluated are costs of surgery plus the excess treatment costs that an obese patient has over and above the treatment costs of a normal-weight patient. The diagnoses that are included for costs assessment are diabetes and cardiovascular disease since these diagnoses are the principal diagnoses associated with obesity. Four different scenarios over the number of surgical operations performed each year are simulated and compared: (1) no surgical operation, (2) 3 000 surgical operations in persons with BMI > 40, (3) 4 000 (BMI > 40), and (4) 5 000 (expanded to BMI > 38).



Results: Comparing Scenario 2 with Scenario 1 results in a net budget impact of on average SEK 121 million per annum or SEK 40 000 per patient. This implies that 55 percent of the cost of surgery, set equal to SEK 90 000 for each patient, has been offset by a reduction in the excess treatment costs of obesity related diseases. Expanding annual surgery from 3000 to 4000 the cost-offset increased to 58%. By expanding annual surgery further from 4000 to 5000 and at the same time expanding the indication for surgery from BMI > 40 to BMI > 38, no cost-offset is obtained.



Conclusion: A cost-minimization strategy for bariatric surgery in Sweden should not expand indication, but rather increase the number of surgeries within the currently accepted indication. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Surgery
volume
101
issue
3
pages
190 - 197
publisher
Finnish Surgical Society
external identifiers
  • wos:000309332500009
  • pmid:22968243
  • scopus:84867083381
ISSN
1799-7267
language
English
LU publication?
yes
id
bdf0aa9a-739a-4e67-82fa-2d7df34e21b5 (old id 3124026)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22968243?dopt=Abstract
date added to LUP
2012-10-03 21:19:38
date last changed
2017-01-01 07:34:42
@article{bdf0aa9a-739a-4e67-82fa-2d7df34e21b5,
  abstract     = {Background:<br/><br>
 The recent substantial increase in the number of obese surgeries performed in Sweden has raised concerns about the budget impact.<br/><br>
<br/><br>
Objective: Our aim in this paper is to present an assessment of the budgetary impact of different policies for surgical intervention for obese and overweight subjects from a healthcare perspective in Sweden. <br/><br>
<br/><br>
Methods: The model simulates the annual expected treatment costs of obesity related diseases and surgery in patients of different sex, age and Body Mass Index (BMI). Costs evaluated are costs of surgery plus the excess treatment costs that an obese patient has over and above the treatment costs of a normal-weight patient. The diagnoses that are included for costs assessment are diabetes and cardiovascular disease since these diagnoses are the principal diagnoses associated with obesity. Four different scenarios over the number of surgical operations performed each year are simulated and compared: (1) no surgical operation, (2) 3 000 surgical operations in persons with BMI &gt; 40, (3) 4 000 (BMI &gt; 40), and (4) 5 000 (expanded to BMI &gt; 38). <br/><br>
<br/><br>
Results: Comparing Scenario 2 with Scenario 1 results in a net budget impact of on average SEK 121 million per annum or SEK 40 000 per patient. This implies that 55 percent of the cost of surgery, set equal to SEK 90 000 for each patient, has been offset by a reduction in the excess treatment costs of obesity related diseases. Expanding annual surgery from 3000 to 4000 the cost-offset increased to 58%. By expanding annual surgery further from 4000 to 5000 and at the same time expanding the indication for surgery from BMI &gt; 40 to BMI &gt; 38, no cost-offset is obtained. <br/><br>
<br/><br>
Conclusion: A cost-minimization strategy for bariatric surgery in Sweden should not expand indication, but rather increase the number of surgeries within the currently accepted indication.},
  author       = {Borg, Sixten and Näslund, I and Persson, Ulf and Odegaard, K},
  issn         = {1799-7267},
  language     = {eng},
  number       = {3},
  pages        = {190--197},
  publisher    = {Finnish Surgical Society},
  series       = {Scandinavian Journal of Surgery},
  title        = {Budget impact analysis of surgical treatment for obesity in sweden.},
  volume       = {101},
  year         = {2012},
}