Does bariatric surgery reduce future hospital costs? A propensity score-matched analysis using UK Biobank Study data

Area of Science:

• Health Economics
• Surgical Outcomes
• Obesity Management

Background:

• Obesity is a significant public health concern associated with increased healthcare utilization and costs.
• Bariatric surgery is an effective treatment for severe obesity, but its long-term economic impact requires thorough evaluation.

Purpose of the Study:

• To estimate and compare the hospital costs for individuals with obesity who underwent bariatric surgery versus those who did not.
• To analyze the short-term and long-term cost implications of bariatric surgery in a real-world healthcare setting.

Main Methods:

• Analysis of the UK Biobank Cohort linked to Hospital Episode Statistics (2006-2017) for adults with obesity.
• Propensity score matching (1:5 ratio) to compare 324 surgical patients with 1506 control participants who did not undergo surgery.
• Assessment of annual and cumulative hospital costs using inverse probability of censoring weighting.

Main Results:

• Bariatric surgery patients incurred significantly higher inpatient costs in the surgery year (€7289 vs. €2635, P < 0.001).
• Surgical patients experienced lower hospital costs in the four years following surgery compared to controls.
• Five-year cumulative hospital costs were €11,176 for surgical patients and €8759 for controls (P = 0.001).

Conclusions:

• Bariatric surgery leads to a substantial increase in inpatient costs during the year of the procedure.
• While subsequent years show decreased costs, these savings do not fully compensate for the initial surgical expenditure within a four-year timeframe.
• The economic evaluation highlights the trade-offs between immediate surgical investment and potential long-term healthcare savings in obesity management.