Clinical Indications, Utilization, and Funding of Bariatric Surgery in Europe.
Clinical Indications, Utilization, and Funding of Bariatric Surgery in Europe.
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DOI：
10.1007/s11695-014-1537-y
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发表时间：
2015-08
期刊：
影响因子：
2.9
通讯作者：
Ahmed, Ahmed R.
中科院分区：
文献类型：
--
作者：
Borisenko, Oleg;Colpan, Zeynep;Dillemans, Bruno;Funch-Jensen, Peter;Hedenbro, Jan;Ahmed, Ahmed R.
本研究的目的是评估目前的利用率，认可的专业协会和卫生技术评估机构的水平，以及欧洲国家的减肥手术的报销水平。我们根据国家临床和委托指南、手术的当前使用、接受手术的患者的特征以及比利时、丹麦、英国、法国、德国、意大利和瑞典的报销费率对减肥手术的适应症进行了分析。数据来自2012年的国家患者登记系统、管理数据库和已发表文献。尽管在临床指南中有明确的共识，但在手术的资格标准方面存在显著差异。在丹麦，如果患者的体重指数（BMI）为40或50 kg/m2，则认为无显著合并症的患者合格。无论在哪个国家，如果患有合并症的患者的BMI <35 kg/m2，则其有资格入选。减肥手术的利用率（每百万人口的手术数量）最高的国家是比利时（928例）、瑞典（761例）和法国（571例），而利用率最低的国家是意大利（128例）、英国（117例）和德国（72例）。患者人群的使用率和平均BMI水平之间存在很强的负相关性（r =-0.909，p = 0.005）。各国的年人均手术支出差异很大，从德国的0.54欧元到比利时的4.33欧元不等。在欧洲国家，减肥手术的临床适应症、利用率和资金来源存在显著差异。本文的在线版本（doi：10.1007/s11695-014-1537-y）包含补充材料，可供授权用户使用。
The objective of this study was to evaluate the current utilization, the level of endorsement by professional societies, and health technology assessment bodies, as well as the reimbursement levels for bariatric surgery in European countries. We performed an analysis of the indications for bariatric surgery based on national clinical and commissioning guidelines, current utilization of surgery, characteristics of patients who underwent surgery, and reimbursement tariffs in Belgium, Denmark, England, France, Germany, Italy, and Sweden. Data were obtained from national patient registries, administrative databases, and published literature for the year 2012. Despite clear consensus outlined in clinical guidelines, significant differences were found in the eligibility criteria for surgery. Patients with no significant comorbidities were deemed eligible if they had a body mass index (BMI) of 40 or 50 kg/m2 in Denmark. Irrespective of the country, patients with comorbidities were eligible if they had a BMI of 35 kg/m2. The highest utilization of bariatric surgery (number of surgeries per 1 M population) was observed in Belgium (928), Sweden (761), and France (571) while Italy (128), England (117), and Germany (72) had the lowest utilization. There was a strong negative correlation between utilization and average BMI level of the patient population (r = −.909, p = 0.005). The annual per capita spending on surgery differed significantly between countries, ranging from €0.54 in Germany to €4.33 in Belgium. There are significant variations in the clinical indications, utilization, and funding of bariatric surgery in European countries. The online version of this article (doi:10.1007/s11695-014-1537-y) contains supplementary material, which is available to authorized users.
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