Economic impact of bariatric Surgery in Australia: 16-year results from the 45 and up study with linked health data

Qing Xia, Julie A. Campbell, Alex Kitsos, Petr Otahal, Michelle Kilpatrick, Alison Venn, David Preen, Barbara de Graaff, Lei Si, Amanda L. Neil, Alexandr Kuzminov, Andrew J. Palmer

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Bariatric surgery is the most effective long-term therapy for severe obesity; however, empirical investigation of its economic impacts has been based on limited samples, short-term costs, and a narrow range of cost categories. This study aimed to evaluate the economic impacts of bariatric surgery in a large cohort of Australians aged ≥ 45 years. 

Methods: N = 1157 operated (surgery) and 1157 non-operated participants were selected from the 45 and Up Study. Data sources included the baseline and follow-up surveys along with linked state and national administrative health datasets. Linear mixed-effects regression predicted the cost trajectory 8 years pre- and post-bariatric surgery, and the difference-in-differences approach evaluated its economic impact. Sensitivity analyses included an approximation of indirect costs and subgroup analysis by surgery type. 

Results: The matched cohort composed 77% female, had an average age of 58.1 ± 5.8 years. Direct healthcare costs increased over time in both groups. Costs for the operated group peaked ($15,884) during the surgery year and became up to 23.8% lower than those for the non-operated group from the second year post-surgery when including indirect costs. Surgery’s economic benefits increased over longer horizons, with a maximum annual cost-saving of $3196 per person in the eighth post-surgery year. However, even after accounting for indirect costs, cumulative cost-savings were not achieved. Subgroup analysis revealed sleeve gastrectomy as the least costly surgical option. 

Conclusion: Higher short-term costs in the surgery year primarily drove inter-group cost differences. The economic value of bariatric surgery lies in the long-term benefits, particularly when considering indirect costs.

Original languageEnglish
Pages (from-to)4413-4424
Number of pages12
JournalObesity Surgery
Volume34
Issue number12
DOIs
Publication statusPublished - 2024

Keywords

  • Bariatric surgery
  • Cost
  • Difference-indifferences
  • Economic impacts
  • Linear mixed-effects regression
  • Sleeve gastrectomy

Fingerprint

Dive into the research topics of 'Economic impact of bariatric Surgery in Australia: 16-year results from the 45 and up study with linked health data'. Together they form a unique fingerprint.

Cite this