Cost-utility of bariatric surgery for morbid obesity in Finland
Cost-utility of bariatric surgery for morbid obesity in Finland
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DOI：
10.1002/bjs.7640
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发表时间：
2011-10-01
影响因子：
9.6
通讯作者：
Sintonen, H.
中科院分区：
文献类型：
--
作者：
Maklin, S.;Malmivaara, A.;Sintonen, H.
背景：本研究的目的是评估减肥手术（胃分流术、袖式胃切除术和胃束带）与芬兰医疗保健系统中普通治疗的成本-效益。方法：从医疗保健提供者的角度进行分析，使用决策树和马尔可夫模型的组合，时间范围为10年。健康相关生活质量通过代表性人群调查进行估计，其他参数值基于登记、系统评价、对照研究和专家意见。结果：在基本病例分析中，减肥手术比普通治疗更有效，成本更低。减肥手术和普通治疗的平均成本分别为33 870和50 495，平均质量调整生命年数分别为7.63和7.05。在敏感性分析中对参数值的不确定性进行了全面检验，结果具有鲁棒性。结论：手术治疗病态肥胖可提高与健康相关的生活质量，减少进一步治疗的需要和总医疗费用。根据这一分析，芬兰医疗保健系统的非手术护理费用在手术后平均5年后会更高。
Background: The aim of this study was to evaluate the cost-utility of bariatric surgery (gastric bypass, sleeve gastrectomy and gastric banding) compared with ordinary treatment in the Finnish healthcare system.Methods: Analysis was done from a healthcare provider's perspective using a combination of a decision tree and a Markov model, with a time horizon of 10 years. Health-related quality of life was estimated from a representative population survey, and other parameter values were based on registers, systematic reviews, controlled studies and expert opinion.Results: In the base-case analysis, bariatric surgery was both more effective and less costly than the ordinary treatment. The mean costs were (sic)33 870 and (sic)50 495, and the mean number of quality-adjusted life-years 7.63 and 7.05, for bariatric surgery and ordinary treatment respectively. Uncertainty around the parameter values was tested comprehensively in sensitivity analyses, and the results were robust.Conclusion: Surgery for morbid obesity increases health-related quality of life, and reduces the need for further treatments and total healthcare costs. According to this analysis, non-operative care would be more costly for the Finnish healthcare system on average after 5 years following surgery.