What is the impact on the healthcare system if access to bariatric surgery is delayed?

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
Ricardo V CohenCarel W Le Roux

Abstract

Bariatric surgery has been available as part of the Brazilian Public Health System for patients with body mass index>40 kg/m2 (or>35 kg/m2 with co-morbidities) since 1999. However, access to surgery is challenging, with eligible patients waiting up to 7 years before surgery. Our objective was to compare costs and effectiveness of different waiting times before surgery versus prompt surgery. Public practice. A Markov microsimulation model compared 5 different strategies: no surgery, prompt surgery, and delaying surgery for 1, 2, 4, and 7 years. Markov tracker variables and states reflected changes in body mass index, type 2 diabetes status (including remission and relapse), and cardiovascular events. Time horizon was 20 years; discount rate, 5%; and the perspective of the Brazilian Public Health System. Effectiveness was calculated as quality adjusted life years. Prompt surgery was the least costly and most effective strategy compared with any delay. Costs increased and effectiveness diminished progressively with the length of delays. Waiting 7 years for surgery was the most expensive and least effective strategy. Prompt surgery maintained dominance in 99.9%, 90.7%, 96.1%, and 94.2% of simulations in probabilistic sensitivity an...Continue Reading

Citations

Jul 26, 2019·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·J GormsenF Helgstrand
Nov 17, 2019·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·Qing XiaAndrew J Palmer
Nov 22, 2019·Obesity Surgery·Selim G GebranYvonne M Rasko
Aug 23, 2020·Obesity Surgery·Estuardo BehrensJorge Laynez
Jun 16, 2018·F1000Research·Vance L Albaugh, Naji N Abumrad
Jul 6, 2020·Obesity Surgery·Emiliano DomeniconiJosé María Foscarini
Feb 26, 2020·Plastic and Reconstructive Surgery. Global Open·Khaled Al-TarrahSunil S Thomas
Jan 26, 2021·Surgical Endoscopy·Gustavo Romero-VelezDiego R Camacho
Nov 16, 2020·Obesity Surgery·Carina A BlumeBeatriz D Schaan
Jan 21, 2021·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Anne JacobsUNKNOWN NOK Research Group
Aug 29, 2021·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Thibaut GalvainDimitri J Pournaras
Sep 12, 2021·Obesity Surgery·Piriyah SinclairAlmantas Maleckas
Nov 13, 2021·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Qing XiaAndrew J Palmer

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

CV Disorders & Type 2 Diabetes

This feed focuses on the association of cardiovascular diseases in patients with type 2 diabetes.

Related Papers

European Review for Medical and Pharmacological Sciences
G Currò, G Navarra
The Journal of the Royal College of Physicians of Edinburgh
W B Leong, S Taheri
© 2022 Meta ULC. All rights reserved