PDF(Pubmed)
Abstract：
OBJECTIVE: To present a comprehensive real-world micro-costing analysis of bariatric surgery.
METHODS: Patients were included if they underwent primary bariatric surgery (gastric banding [GB], gastric bypass [GBP] and sleeve gastrectomy [SG]) between 2013 and 2019. Costs were disaggregated into cost items and average-per-patient costs from the Australian healthcare systems perspective were expressed in constant 2019 Australian dollars for the entire cohort and subgroup analysis. Annual population-based costs were calculated to capture longitudinal trends. A generalized linear model (GLM) predicted the overall bariatric-related costs.
RESULTS: N = 240 publicly funded patients were included, with the waitlist times of ≤ 10.7 years. The mean direct costs were $11,269. The operating theatre constituted the largest component of bariatric-related costs, followed by medical supplies, salaries, critical care use, and labour on-costs. Average cost for SG ($12,632) and GBP ($15,041) was higher than that for GB ($10,049). Operating theatre accounted for the largest component for SG/GBP costs, whilst medical supplies were the largest for GB. We observed an increase in SG and a decrease in GB procedures over time. Correspondingly, the main cost driver changed from medical supplies in 2014-2015 for GB procedures to operating theatre for SG thereafter. GLM model estimates of bariatric average cost ranged from $7,580 to $36,633.
CONCLUSIONS: We presented the first detailed characterization of the scale, disaggregated profile and determinants of bariatric-related costs, and examined the evolution of resource utilization patterns and costs, reflecting the shift in the Australian bariatric landscape over time. Understanding these patterns and forecasting of future changes are critical for efficient resource allocation.
METHODS: Patients were included if they underwent primary bariatric surgery (gastric banding [GB], gastric bypass [GBP] and sleeve gastrectomy [SG]) between 2013 and 2019. Costs were disaggregated into cost items and average-per-patient costs from the Australian healthcare systems perspective were expressed in constant 2019 Australian dollars for the entire cohort and subgroup analysis. Annual population-based costs were calculated to capture longitudinal trends. A generalized linear model (GLM) predicted the overall bariatric-related costs.
RESULTS: N = 240 publicly funded patients were included, with the waitlist times of ≤ 10.7 years. The mean direct costs were $11,269. The operating theatre constituted the largest component of bariatric-related costs, followed by medical supplies, salaries, critical care use, and labour on-costs. Average cost for SG ($12,632) and GBP ($15,041) was higher than that for GB ($10,049). Operating theatre accounted for the largest component for SG/GBP costs, whilst medical supplies were the largest for GB. We observed an increase in SG and a decrease in GB procedures over time. Correspondingly, the main cost driver changed from medical supplies in 2014-2015 for GB procedures to operating theatre for SG thereafter. GLM model estimates of bariatric average cost ranged from $7,580 to $36,633.
CONCLUSIONS: We presented the first detailed characterization of the scale, disaggregated profile and determinants of bariatric-related costs, and examined the evolution of resource utilization patterns and costs, reflecting the shift in the Australian bariatric landscape over time. Understanding these patterns and forecasting of future changes are critical for efficient resource allocation.
摘要：
目的：对减肥手术进行全面的微观成本分析。
方法：如果患者接受了原发性减肥手术（胃束带术[GB]，胃旁路术[GBP]和袖状胃切除术[SG])，2013年至2019年。成本被分解为成本项目，从澳大利亚医疗保健系统的角度来看，每位患者的平均成本以2019年恒定澳元表示，用于整个队列和亚组分析。计算基于人口的年度成本以捕捉纵向趋势。广义线性模型(GLM)预测了与减肥相关的总体成本。
结果：包括240名公共资助的患者，等候时间≤10.7年。平均直接成本为11269美元。手术室是减肥相关费用的最大组成部分，其次是医疗用品，工资,重症监护使用，和劳动力成本。SG（12,632美元）和GBP（15,041美元）的平均成本高于GB（10,049美元）。手术室占SG/GBP成本的最大组成部分，而医疗用品是GB最大的。我们观察到随着时间的推移SG增加和GB程序减少。相应地,主要成本驱动因素从2014-2015年GB手术的医疗用品转变为此后SG的手术室.GLM模型估计的减肥平均费用从7,580美元到36,633美元不等。
结论：我们介绍了量表的第一个详细表征，减肥相关费用的分类概况和决定因素，并研究了资源利用模式和成本的演变，反映了澳大利亚减肥领域随着时间的推移而发生的变化。了解这些模式并预测未来的变化对于有效的资源分配至关重要。
方法：如果患者接受了原发性减肥手术（胃束带术[GB]，胃旁路术[GBP]和袖状胃切除术[SG])，2013年至2019年。成本被分解为成本项目，从澳大利亚医疗保健系统的角度来看，每位患者的平均成本以2019年恒定澳元表示，用于整个队列和亚组分析。计算基于人口的年度成本以捕捉纵向趋势。广义线性模型(GLM)预测了与减肥相关的总体成本。
结果：包括240名公共资助的患者，等候时间≤10.7年。平均直接成本为11269美元。手术室是减肥相关费用的最大组成部分，其次是医疗用品，工资,重症监护使用，和劳动力成本。SG（12,632美元）和GBP（15,041美元）的平均成本高于GB（10,049美元）。手术室占SG/GBP成本的最大组成部分，而医疗用品是GB最大的。我们观察到随着时间的推移SG增加和GB程序减少。相应地,主要成本驱动因素从2014-2015年GB手术的医疗用品转变为此后SG的手术室.GLM模型估计的减肥平均费用从7,580美元到36,633美元不等。
结论：我们介绍了量表的第一个详细表征，减肥相关费用的分类概况和决定因素，并研究了资源利用模式和成本的演变，反映了澳大利亚减肥领域随着时间的推移而发生的变化。了解这些模式并预测未来的变化对于有效的资源分配至关重要。
