scholarly journals Impacts of bariatric surgery in health outcomes and health care costs in Brazil: Interrupted time series analysis of multi-panel data

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
José Antonio Orellana Turri ◽  
Nana Kwame Anokye ◽  
Lionai Lima dos Santos ◽  
José Maria Soares Júnior ◽  
Edmund Chada Baracat ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Time Series ◽  
Health Status ◽  
Health Outcomes ◽  
Health Care Costs ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Care Costs ◽  
Multiple Health

Abstract Background The increasing burden of obesity generates significant socioeconomic impacts for individuals, populations, and national health systems worldwide. The literature on impacts and cost-effectiveness of obesity-related interventions for prevention and treatment of moderate to severe obesity indicate that bariatric surgery presents high costs associated with high effectiveness in improving health status referring to certain outcomes; however, there is a lack of robust evidence at an individual-level estimation of its impacts on multiple health outcomes related to obesity comorbidities. Methods The study encompasses a single-centre retrospective longitudinal analysis of patient-level data using micro-costing technique to estimate direct health care costs with cost-effectiveness for multiple health outcomes pre-and post-bariatric surgery. Data from 114 patients who had bariatric surgery at the Hospital of Clinics of the University of Sao Paulo during 2018 were investigated through interrupted time-series analysis with generalised estimating equations and marginal effects, including information on patients' characteristics, lifestyle, anthropometric measures, hemodynamic measures, biochemical exams, and utilisation of health care resources during screening (180 days before) and follow-up (180 days after) of bariatric surgery. Results The preliminary statistical analysis showed that health outcomes presented improvement, except cholesterol and VLDL, and overall direct health care costs increased after the intervention. However, interrupted time series analysis showed that the rise in health care costs is attributable to the high cost of bariatric surgery, followed by a statistically significant decrease in post-intervention health care costs. Changes in health outcomes were also statistically significant in general, except in cholesterol and LDL, leading to significant improvements in patients' health status after the intervention. Conclusions Trends multiple health outcomes showed statistically significant improvements in patients' health status post-intervention compared to trends pre-intervention, resulting in reduced direct health care costs and the burden of obesity.

scholarly journals Impacts of bariatric surgery in health outcomes and health care costs in Brazil: Interrupted time series analysis of multi-panel data

2021 ◽  
Author(s):  
Jose Antonio Orellana Turri ◽  
Nana Kwame Anokye ◽  
Lionai Lima dos Santos ◽  
José Maria Soares Júnior ◽  
Edmund Chada Baraccat ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Time Series ◽  
Health Status ◽  
Health Outcomes ◽  
Health Care Costs ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Care Costs ◽  
Multiple Health

Abstract Background: The increasing burden of obesity generates significant socioeconomic impacts for individuals, populations, and national health systems worldwide. The literature on impacts and cost-effectiveness of obesity-related interventions for prevention and treatment of moderate to severe obesity indicate that bariatric surgery presents high costs associated with high effectiveness in improving health status referring to certain outcomes; however, there is a lack of robust evidence at an individual-level estimation of its impacts on multiple health outcomes related to obesity comorbidities.Methods: The study encompasses a single-centre retrospective longitudinal analysis of patient-level data using micro-costing technique to estimate direct health care costs with cost-effectiveness for multiple health outcomes pre-and post-bariatric surgery. Data from 114 patients who had bariatric surgery at the Hospital of Clinics of the University of Sao Paulo during 2018 were investigated through interrupted time-series analysis with generalised estimating equations and marginal effects, including information on patients' characteristics, lifestyle, anthropometric measures, hemodynamic measures, biochemical exams, and utilisation of health care resources during screening (180 days before) and follow-up (180 days after) of bariatric surgery.Results: The preliminary statistical analysis showed that health outcomes presented improvement, except cholesterol and VLDL, and overall direct health care costs increased after the intervention. However, interrupted time series analysis showed that the rise in health care costs is attributable to the high cost of bariatric surgery, followed by a statistically significant decrease in post-intervention health care costs. Changes in health outcomes were also statistically significant in general, except in cholesterol and LDL, leading to significant improvements in patients' health status after the intervention.Conclusions: Trends multiple health outcomes showed statistically significant improvements in patients' health status post-intervention compared to trends pre-intervention, resulting in reduced direct health care costs and the burden of obesity.

scholarly journals Impacts of bariatric surgery on costs and health outcomes of patients in Brazil: Interrupted time series analysis of multi-panel data

2020 ◽  
Author(s):  
Jose Antonio Orellana Turri ◽  
Edmund Chada Baracat ◽  
Jose Maria Soares ◽  
Lionai Lima dos Santos ◽  
Marco Aurelio Santo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Time Series ◽  
Health Status ◽  
Health Outcomes ◽  
Severe Obesity ◽  
Interrupted Time Series ◽  
Direct Costs ◽  
Interrupted Time Series Analysis ◽  
Post Intervention

Obesity is one of the most important public health problems worldwide, presenting significant socioeconomic impacts in health systems. Considering the rising costs of health care and the escalating burden of obesity in diverse countries, there has been increasing trends in examination of cost-effectiveness of health interventions towards prevention and treatment of obesity and its effects on comorbidities. Bariatric surgery has been considered an effective intervention for reducing moderate to severe obesity and improvement of obesity-related morbidities. Methodology: Interrupted Time-Series Analysis (ITSA) on costs and health outcomes from retrospective cohort of 114 patients who had bariatric surgery at the Hospital of Clinics from the University of Sao Paulo. Medical records encompassing complete data on anthropometric, hemodynamic and biochemical parameters, utilization of resources and costs for health care procedures and regular assessments of patients health status associated with bariatric surgery at individual level were included in the study. Data on utilization of resources during outpatient and inpatient health care were used for estimation of patients direct costs referring to bariatric surgery, and 6-month pre- and post-intervention periods, adopting health system perspective in micro-costing approach. Results: Mean direct costs of hospitalization (-US$2,762.22; -23.2%), image exams (-US$7.53; -0.8%) and medication (-US$175.37; -25,7%) presented decrease after bariatric surgery, and total direct cost (US$1,375.37; +138%), consultations (US$0.42; +2.4%) and laboratory exams (US$68.96; +63.4%) had increase. Reduction in weight, BMI, LDL, triglycerides, insulin, glucose-linked hemoglobin, and glucose showed improvements in patients health status after bariatric surgery. Cholesterol, VLDL, and HDL presenting increase after surgery. Conclusion: Bariatric surgery represents an effective intervention for treatment of moderate to severe obesity with extensive benefits regarding health promotion and reduction of burden of disease. Trends in direct costs and multiple health outcomes showed post-intervention improvements in patients health status and reduction of health care needs of individuals.

scholarly journals The effect of bariatric surgery on health care costs: A synthetic control approach using Bayesian structural time series

2019 ◽  
Vol 28 (11) ◽  
pp. 1293-1307
Author(s):  
Christoph F. Kurz ◽  
Martin Rehm ◽  
Rolf Holle ◽  
Christina Teuner ◽  
Michael Laxy ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Time Series ◽  
Health Care Costs ◽  
Synthetic Control ◽  
Control Approach ◽  
Structural Time Series ◽  
Structural Time ◽  
Care Costs

Les Nouveaux Miserables: Modem Victims of Social Asphyxia

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 851-857
Author(s):  
David R. Smith
Keyword(s):  
Health Care ◽  
Health Status ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Services ◽  
Preventive Services ◽  
Medical Care System ◽  
Care Services ◽  
Care Costs ◽  
Care System

During the past 30 years, social and economic barriers to health care services have increased for many Americans, especially for the nation's most vulnerable populations. Health status actually has declined for certain populations during this time. Meanwhile, national attention has been focused primarily on containing health care costs and on devising strategies for reforming the financing of health care rather than strategies for achieving improvements in the health status of the population. Existing methods of financing health care services, health research priorities, the increasing centralization and compartmentalization of health care services, and the recent failure of national health reform all serve to hinder this nation's progress towards developing a comprehensive and accountable health care system focused on promoting and achieving improved health as well as treating sickness. Recent changes in the health care marketplace, however, including a growing movement toward measuring the outcomes of medical treatments and an emphasis on improving the quality of services, have increased interest among payers and providers of health care services in investing in preventive services. Health maintenance organizations and other integrated health care delivery systems are beginning to devise incentives for increasing preventive care as well as for containing costs. The transformation of the nation's current medical care system into a true health care system will require innovative strategies designed to merge the existing fragmented array of services into coordinated and comprehensive systems for delivering primary and preventive health care services in community settings. The community-Oriented Primary Care concept successfully blends these functions and has achieved measurable results in reducing health care costs and improving access to preventive services for identified populations. There is flexibility in existing funding sources to promote preventive services in various public and private health care settings and to assist in the transformation from a disease-oriented medical care system to one focused on health.

scholarly journals Osteoarthritis pain in the workforce: evaluating its impact on health status, productivity, and health care costs

2011 ◽  
Vol 12 (4) ◽  
pp. P29
Author(s):  
A. Sadosky ◽  
M. DiBonaventura ◽  
S. Gupta ◽  
M. McDonald
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Care Costs ◽  
Osteoarthritis Pain ◽  
Care Costs

scholarly journals Digital cognitive behavioural therapy for insomnia and primary care costs in England: an interrupted time series analysis

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0146
Author(s):  
Chris Sampson ◽  
Eleanor Bell ◽  
Amanda Cole ◽  
Christopher B Miller ◽  
Tracey Marriott ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Cognitive Behavioural Therapy ◽  
Interrupted Time Series ◽  
Behavioural Therapy ◽  
Interrupted Time Series Analysis ◽  
Cognitive Behavioural ◽  
Before And After ◽  
Quasi Experimental ◽  
Care Costs

BackgroundSleepio is an automated digital programme that delivers cognitive behavioural therapy for insomnia (dCBT-I). Sleepio has been proven effective in improving sleep difficulties. However, evidence for the possible impact of Sleepio use on health care costs in the United Kingdom has not previously been developed.AimWe sought to identify the effect of a population-wide rollout of Sleepio in terms of primary care costs in the National Health Service (NHS) in England.Design & settingThe study was conducted in the Thames Valley region of England, where access to Sleepio was made freely available to all residents between October 2018 and January 2020. The study relies on a quasi-experimental design, using an interrupted time series to compare the trend in primary care costs before and after the rollout of Sleepio.MethodWe use primary care data for people with relevant characteristics from nine general practices in Buckinghamshire. Primary care costs include general practice contacts and prescriptions. Segmented regression analysis was used to estimate primary and secondary outcomes.ResultsFor the 10,704 patients included in our sample, the total saving over the 65-week follow-up period was £71,027. This corresponds to £6.64 per person in our sample or around £70.44 per Sleepio user. Secondary analyses suggest that savings may be driven primarily by reductions in prescribing.ConclusionSleepio rollout reduced primary care costs. National adoption of Sleepio may reduce primary care costs by £20 million in the first year. The expected impact on primary care costs in any particular setting will depend on the uptake of Sleepio.

scholarly journals Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the Swedish Obese Subjects study

2015 ◽  
Vol 3 (11) ◽  
pp. 855-865 ◽  
Author(s):  
Catherine Keating ◽  
Martin Neovius ◽  
Kajsa Sjöholm ◽  
Markku Peltonen ◽  
Kristina Narbro ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Health Care Costs ◽  
Obese Subjects ◽  
Care Costs ◽  
Glucose Status

Does rural health system reform aimed at improving access to primary health care affect hospitalization rates? An interrupted time series analysis of national policy reforms in Iran

2019 ◽  
Vol 24 (2) ◽  
pp. 73-80 ◽  
Author(s):  
Arash Rashidian ◽  
Sedigheh Salavati ◽  
Hanan Hajimahmoodi ◽  
Mehrnaz Kheirandish
Keyword(s):  
Health Care ◽  
Time Series ◽  
Primary Health Care ◽  
Time Series Analysis ◽  
Rural Health ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Hospitalization Rates ◽  
Primary Health

Objectives To evaluate the effects of rural health insurance and family physician reforms on hospitalization rates in Iran. Methods An interrupted time series analysis of national monthly hospitalization rates in Iran (2003–2014), starting from two years before the intervention. Segmented regression analysis was used to assess the effects of the reforms on hospitalization rates. Results The analyses showed that hospitalization rates increased one year after the initiation of the reforms: 1.55 (95% CI: 1.24–1.86) additional hospitalizations per 1000 rural inhabitants per month (‘immediate effect’). This increase was followed by a further gradual increase of 0.034 per 1000 inhabitants per month (95% CI: 0.02–0.04). The gradual monthly increase continued for two years after the reforms. The higher hospitalization rates were maintained in the following years. We observed a significant increase in hospitalization rates at a national level in rural areas that continued for over 10 years after the policy implementation. Conclusion Primary health care reforms are often proposed for their efficiency outcomes (i.e. reduction in costs and use of hospitals) as well as their impact on improving health outcomes. We demonstrated that in populations with unmet needs, such reforms are likely to substantially increase hospitalization rates. This is an important consideration for successful design and implementation of interventions aimed at achieving universal health coverage in low- and middle-income countries.

Sign in / Sign up

Export Citation Format

Share Document