Long-term Costs and Return on Investment for Bariatric Surgery

减肥手术的长期成本和投资回报

基本信息

  • 批准号:
    10375567
  • 负责人:
  • 金额:
    $ 67.37万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2020
  • 资助国家:
    美国
  • 起止时间:
    2020-07-17 至 2024-03-31
  • 项目状态:
    已结题

项目摘要

ABSTRACT Bariatric surgery is the most effective treatment for severe obesity, yet only 1-2% of eligible patients undergo surgery annually. This low rate of bariatric surgery uptake persists despite strong evidence of the high cost of severe obesity and the superiority of bariatric procedures in inducing clinically significant and sustained weight loss, prolonged survival, and major improvements in obesity-related health conditions [i.e., type 2 diabetes (T2DM)] when compared to usual medical care. Barriers to use of bariatric surgery include patient and physician knowledge and attitudes towards these procedures; lack of resources for non-surgical treatment of severe obesity; and high patient costs arising from inadequate insurance coverage. Inadequate coverage and significant pre-surgical requirements is common among private insurers despite Medicare providing full coverage for bariatric procedures for >20 years and evidence that bariatric surgery is cost-effective at <$50,000/QALY. This continued gap in coverage of bariatric surgery appears to be driven by concerns about the long-term costs of complications and surgery’s large potential budget impact, since ~15% of U.S. adults are eligible for bariatric surgery and the cost per procedure is high ($20-30,000/procedure). As a result, payers may require evidence that bariatric surgery is cost-saving before providing broader coverage. There are four major gaps in the economic evidence that are barriers to expansion of private insurance coverage for bariatric surgery. We propose to address these evidence gaps by comparing the 5- and 10-year expenditures of ~30,000 patients who previously underwent the two most common bariatric procedures (SG and RYGB) and a large cohort (~90,000) of rigorously matched non-surgical patients with severe obesity from years 2005-2019 with follow-up through 2021. Over 5,000 surgical patients and 15,000 nonsurgical patients with index dates before 2012 will have data at 10 years or beyond, making this the largest economic study to date and the study with the longest follow-up. We propose to address three aims: Aim 1: Compare 5- and 10-year changes in total costs of health care among patients undergoing SG and RYGB versus matched non-surgical patients with severe obesity. Aim 2: Examine heterogeneity of the effect of surgery on costs to understand whether there are clinical subgroups of patients with severe obesity who have more favorable post-surgical cost trajectories. • Aim 2a: We will examine heterogeneity among all surgical patients and matched nonsurgical patients. • Aim 2b: We will examine heterogeneity among surgical patients with T2DM and their matches. Aim 3: Estimate time to break-even for each subgroup identified in aim 2 to identify the return-on-investment over a 5- to 10-year time frame after accounting for the initial costs of surgery.
摘要

项目成果

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David Eric Arterburn其他文献

David Eric Arterburn的其他文献

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{{ truncateString('David Eric Arterburn', 18)}}的其他基金

Long-term Costs and Return on Investment for Bariatric Surgery
减肥手术的长期成本和投资回报
  • 批准号:
    10026626
  • 财政年份:
    2020
  • 资助金额:
    $ 67.37万
  • 项目类别:
Long-term Costs and Return on Investment for Bariatric Surgery
减肥手术的长期成本和投资回报
  • 批准号:
    10218157
  • 财政年份:
    2020
  • 资助金额:
    $ 67.37万
  • 项目类别:
Long-term Costs and Return on Investment for Bariatric Surgery
减肥手术的长期成本和投资回报
  • 批准号:
    10597046
  • 财政年份:
    2020
  • 资助金额:
    $ 67.37万
  • 项目类别:
Moving to Health: How changing built environments impact weight and glycemic control
走向健康:改变建筑环境如何影响体重和血糖控制
  • 批准号:
    9980377
  • 财政年份:
    2017
  • 资助金额:
    $ 67.37万
  • 项目类别:
Moving to Health: How changing built environments impact weight and glycemic control
走向健康:改变建筑环境如何影响体重和血糖控制
  • 批准号:
    9754816
  • 财政年份:
    2017
  • 资助金额:
    $ 67.37万
  • 项目类别:
Moving to Health: How changing built environments impact weight and glycemic control
走向健康:改变建筑环境如何影响体重和血糖控制
  • 批准号:
    10200029
  • 财政年份:
    2017
  • 资助金额:
    $ 67.37万
  • 项目类别:
Long-term Benefits and Risks of Bariatric Surgery in Integrated Care Systems
综合护理系统中减肥手术的长期益处和风险
  • 批准号:
    9329410
  • 财政年份:
    2015
  • 资助金额:
    $ 67.37万
  • 项目类别:
Long-term Benefits and Risks of Bariatric Surgery in Integrated Care Systems
综合护理系统中减肥手术的长期益处和风险
  • 批准号:
    9136837
  • 财政年份:
    2015
  • 资助金额:
    $ 67.37万
  • 项目类别:
Long-term Benefits and Risks of Bariatric Surgery in Integrated Care Systems
综合护理系统中减肥手术的长期益处和风险
  • 批准号:
    8940898
  • 财政年份:
    2015
  • 资助金额:
    $ 67.37万
  • 项目类别:
Impact of Bariatric Surgery on Long-term Diabetes Remission and Complications
减肥手术对长期糖尿病缓解和并发症的影响
  • 批准号:
    8672631
  • 财政年份:
    2012
  • 资助金额:
    $ 67.37万
  • 项目类别:

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