Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

Abstract

et al. Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records. Health Serv Deliv Res 2016;4(17). Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/12. The contractual start date was in October 2013. The final report began editorial review in October 2015 and was accepted for publication in February 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinion...

Long-term effects of bariatric surgery on acute kidney injury: a propensity-matched cohort in the UK Clinical Practice Research Datalink

“…In a recent analysis about 40% of bariatric surgery operations in the UK were privately funded. 31 Thus, the intervention group might have a higher socioeconomic status than the non-exposed group, in which similar patients would not be able to afford surgery. Since the socioeconomic background is an important determinant of health outcomes and was an unmeasured potential confounder not considered in the matching process, this could have led to more positive health outcomes in the intervention group irrespective of surgery and to an overestimation of the effect.…”

Harveian Oration 2016: Some observations on the causes and consequences of obesity

“…Unfortunately for M, the UK lags far behind most advanced countries in the provision of 'metabolic surgery' 116 and she will probably face many barriers to accessing this highly successful treatment. 117 The National Institute for Health and Care Excellence (NICE) has recently published a quality standard for the clinical assessment and management of obesity, 118 which includes the explicit recognition of the important role that bariatric surgery plays. It is to be hoped that this will lead to a marked change in behaviour of health commissioners and providers, so that this highly cost-effective form of care can be delivered to patients such as M.…”

Developing the role of electronic health records in economic evaluation

“…The National Institute for Health and Care Excellence (NICE) recommends coverage of bariatric surgery for patients with morbid obesity (BMI ≥ 40) and those with severe obesity (BMI 35-39.9 kg/m 2 ) who have at least one comorbidity. To examine whether it would be cost-effective to extend coverage to patients with severe obesity and no comorbidity, EHR data were used to test the cost-effectiveness of bariatric surgery for this group using literature-based and EHR-derived intervention effects [3,12]. EHR data allows for modeling of costs and outcomes for a population that would otherwise not have had access to the intervention by using the incidence, prevalence, mortality and health care utilization found in the longitudinal patient records [3].…”