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- W2900092210 abstract "Within the Australian public hospital setting, no studies have previously reported total hospital utilisation and costs (pre/postoperatively), and costed patient-level pathways for primary bariatric surgery and surgical sequelae (including secondary surgery) informed by Australia’s Independent Hospitals Pricing Authority’s Activity Based Funding (ABF) model. We aimed to provide our government health partner with much needed information regarding accurate resource use and costs of bariatric surgery for people with severe obesity waitlisted for, and who then undergo, bariatric surgery in Tasmanian public hospitals. Data were extracted from administrative sources routinely collected, clinically-coded/costed according to ABF. Inpatient episodes-of-care, associated length-of-stay and ABF costs (2015 Australian dollars) were investigated for the fiscal-years 2007/08 to 2015/16. Subgroup analyses were conducted. N=105 publicly-waitlisted severely-obese patients with multi-morbidity underwent primary bariatric surgery (laparoscopic adjustable gastric band (LAGB) n=89; sleeve gastrectomy (SG) n=16) in Tasmanian public hospitals. Annual total costs (TC) 1 year preoperatively were $434,710 and 3 years postoperatively were $122,820. TC and episodes-of-care decreased at 3 years postoperatively for the entire cohort. The average cost/episode-of-care decreased in the first year postoperatively for people with diabetes, from $6,984 to $5,610/episode-of-care. TC (pre/postoperative over 8 years) for all inpatient episodes-of-care (n=779 episodes-of-care) were $5,791,530. Mean costs for primary LAGB and SG bariatric surgery were $14,071 and $14,448, respectively. Twenty-seven LAGB patients (30%) required further surgery due to surgical sequelae (including revisional/secondary surgery) (n=58 episodes-of-care), and 56% of these episodes-of-care were secondary LAGB device-related (mostly port/reservoir-related) with mean costs of $6,031. Our patient-level analyses provided much needed information regarding the costs of bariatric surgery to the Tasmanian public hospital system. Costs could be mitigated by substituting LABG with SG when clinically appropriate, taking into account our small SG sample size. Three years postoperatively, episodes-of-care and costs reduced substantially versus preoperatively, particularly for people with diabetes/cardiovascular disease." @default.
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- W2900092210 date "2018-09-01" @default.
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- W2900092210 title "A Cost-Outcome Study: A Real-World Investigation of Long-Term Inpatient Hospital Utilisation and Costs for a Retrospective Cohort of Bariatric Surgery Patients in an Australian Public Hospital System Based on Australia’s Activity Based Funding Model" @default.
- W2900092210 doi "https://doi.org/10.1016/j.jval.2018.07.847" @default.
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