PMID- 34043776
OWN - NLM
STAT- MEDLINE
DCOM- 20211004
LR  - 20211207
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Linking)
VI  - 108
IP  - 5
DP  - 2021 May 27
TI  - Bariatric surgery is expensive but improves co-morbidity: 5-year assessment of 
      patients with obesity and type 2 diabetes.
PG  - 554-565
LID - 10.1002/bjs.11970 [doi]
AB  - BACKGROUND: Bariatric surgery can be effective in weight reduction and diabetes 
      remission in some patients, but is expensive. The costs of bariatric surgery in 
      patients with obesity and type 2 diabetes mellitus (T2DM) were explored here. 
      METHODS: Population-based retrospectively gathered data on patients with obesity 
      and T2DM from the Hong Kong Hospital Authority (2006-2017) were evaluated. Direct 
      medical costs from baseline up to 60 months were calculated based on the 
      frequency of healthcare service utilization and dispensing of diabetes 
      medication. Charlson Co-morbidity Index (CCI) scores and co-morbidity rates were 
      measured to compare changes in co-morbidities between surgically treated and 
      control groups over 5 years. One-to-five propensity score matching was applied. 
      RESULTS: Overall, 401 eligible surgical patients were matched with 1894 
      non-surgical patients. Direct medical costs were much higher for surgical than 
      non-surgical patients in the index year (euro36 752 and euro5788 respectively; 
      P < 0.001) mainly owing to the bariatric procedure. The 5-year cumulative costs 
      incurred by surgical patients were also higher (euro54 135 versus euro28 603; 
      P < 0.001). Although patients who had bariatric surgery had more visits to 
      outpatient and allied health professionals than those who did not across the 
      5-year period, surgical patients had shorter length of stay in hospitals than 
      non-surgical patients in year 2-5. Surgical patients had significantly better CCI 
      scores than controls after the baseline measurement (mean 3.82 versus 4.38 at 
      5 years; P = 0.016). Costs of glucose-lowering medications were similar between 
      two groups, except that surgical patients had significantly lower costs of 
      glucose-lowering medications in year 2 (euro973 versus euro1395; P = 0.012). 
      CONCLUSION: Bariatric surgery in obese patients with T2DM is expensive, but leads 
      to an improved co-morbidity profile, and reduced length of hospitalization.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of BJS 
      Society Ltd. All rights reserved. For permissions, please email: 
      journals.permissions@oup.com.
FAU - Wu, T
AU  - Wu T
AUID- ORCID: 0000-0003-3609-5016
AD  - Department of Family Medicine and Primary Care, University of Hong Kong, Hong 
      Kong SAR, China.
FAU - Wong, S K H
AU  - Wong SKH
AD  - Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China.
AD  - Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Hong 
      Kong, SAR, China.
FAU - Law, B T T
AU  - Law BTT
AD  - Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery, 
      University of Hong Kong, Hong Kong, SAR, China.
FAU - Grieve, E
AU  - Grieve E
AUID- ORCID: 0000-0002-4115-2882
AD  - Health Economics and Health Technology Assessment, Institute of Health and 
      Well-being, University of Glasgow, Glasgow, UK.
FAU - Wu, O
AU  - Wu O
AUID- ORCID: 0000-0002-0570-6016
AD  - Health Economics and Health Technology Assessment, Institute of Health and 
      Well-being, University of Glasgow, Glasgow, UK.
FAU - Tong, D K H
AU  - Tong DKH
AD  - Surgery Centre, Hong Kong Sanatorium and Hospital Hong Kong, SAR, China.
FAU - Leung, D K W
AU  - Leung DKW
AD  - Department of Surgery, United Christian Hospital Hong Kong, SAR, China.
FAU - Ng, E K W
AU  - Ng EKW
AUID- ORCID: 0000-0001-7219-5810
AD  - Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China.
AD  - Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Hong 
      Kong, SAR, China.
FAU - Lam, C L K
AU  - Lam CLK
AUID- ORCID: 0000-0001-7536-8481
AD  - Department of Family Medicine and Primary Care, University of Hong Kong, Hong 
      Kong SAR, China.
FAU - Wong, C K H
AU  - Wong CKH
AUID- ORCID: 0000-0002-6895-6071
AD  - Department of Family Medicine and Primary Care, University of Hong Kong, Hong 
      Kong SAR, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
RN  - 0 (Hypoglycemic Agents)
SB  - IM
CIN - Br J Surg. 2021 Aug 19;108(8):e281. PMID: 33975335
CIN - Br J Surg. 2021 Aug 19;108(8):e280. PMID: 34115829
MH  - Ambulatory Care/economics/statistics & numerical data
MH  - Bariatric Surgery/*economics
MH  - Case-Control Studies
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/*drug therapy/economics
MH  - Emergency Service, Hospital/economics/statistics & numerical data
MH  - Female
MH  - Hong Kong/epidemiology
MH  - Humans
MH  - Hypoglycemic Agents/economics/therapeutic use
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Obesity/*economics/surgery
MH  - Office Visits/economics/statistics & numerical data
MH  - Retrospective Studies
EDAT- 2021/05/28 06:00
MHDA- 2021/10/05 06:00
CRDT- 2021/05/27 17:48
PHST- 2020/03/09 00:00 [received]
PHST- 2020/05/06 00:00 [revised]
PHST- 2020/07/09 00:00 [accepted]
PHST- 2021/05/27 17:48 [entrez]
PHST- 2021/05/28 06:00 [pubmed]
PHST- 2021/10/05 06:00 [medline]
AID - 6287138 [pii]
AID - 10.1002/bjs.11970 [doi]
PST - ppublish
SO  - Br J Surg. 2021 May 27;108(5):554-565. doi: 10.1002/bjs.11970.