Multi-centre micro-costing of Roux-En-Y Gastric bypass, sleeve gastrectomy and adjustable gastric banding procedures for the treatment of severe, complex obesity
Multi-centre micro-costing of Roux-En-Y Gastric bypass, sleeve gastrectomy and adjustable gastric banding procedures for the treatment of severe, complex obesity
Background: There is a growing interest in comparing the effectiveness and costs of alternative forms of bariatric surgery. We aimed to examine the per-patient, procedural costs of Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and adjustable gastric banding (AGB) in the United Kingdom.
Methods: Multi-centre (two National Health Service; NHS and one private hospital) micro-costing, using a time-and-motion study. Prospective collection of surgery times, staff quantities, equipment, instruments and consumables for 12 patients (four RYGB, five SG, three AGB) from patients’ first surgeon interaction on the day of surgery to departure from the theatre recovery area. Costs were attached to quantities and mean costs compared. Sensitivity and scenario analyses assessed the impact of varying surgery inputs and consideration of additional plausible factors respectively on total costs.
Results: Mean procedural costs were £5002 for RYGB, £4306 for SG and £2527 for AGB. Varying staff seniority or altering procedure times had small impacts on costs (± 4–6%). Reducing prices of consumables by 20% reduced costs by 10–13%. Accounting for differences in surgical technique by altering the number of staple reloads used impacted costs by ± 7–10%. Adjusted total costs from scenario analyses were similar to NHS tariffs for RYGB and SG (difference of £51 and -£119 respectively) but were much lower for AGB (difference of £1982).
Conclusions: These detailed costs will allow for more precise reimbursement of bariatric surgery and support comprehensive assessments of cost-effectiveness. Additional work to investigate costs of post-surgical care, re-operations and life-long support received by patients following surgery is required.
474–484
Doble, Brett
446415d3-2b6e-4375-b1af-330ef6cfc3c0
Welbourn, Richard
8c5383cc-ba8b-4fd2-a3da-a3d6ddce943e
Carter, Nicholas
0ebb6853-a7f7-486f-ac34-e13a666d3f64
Byrne, James
e3d5b8fe-1b69-441c-a173-e084fe5372a6
Rogers, Chris A
d29926e1-acbe-48e5-a085-23552f635812
Blazeby, J.M.
6953771d-d47b-4878-be76-bca8a9e8531d
By-Band-Sleeve Trial Management Group
15 February 2019
Doble, Brett
446415d3-2b6e-4375-b1af-330ef6cfc3c0
Welbourn, Richard
8c5383cc-ba8b-4fd2-a3da-a3d6ddce943e
Carter, Nicholas
0ebb6853-a7f7-486f-ac34-e13a666d3f64
Byrne, James
e3d5b8fe-1b69-441c-a173-e084fe5372a6
Rogers, Chris A
d29926e1-acbe-48e5-a085-23552f635812
Blazeby, J.M.
6953771d-d47b-4878-be76-bca8a9e8531d
Doble, Brett, Welbourn, Richard, Carter, Nicholas and Byrne, James
,
By-Band-Sleeve Trial Management Group
(2019)
Multi-centre micro-costing of Roux-En-Y Gastric bypass, sleeve gastrectomy and adjustable gastric banding procedures for the treatment of severe, complex obesity.
Obesity Surgery, 29 (2), .
(doi:10.1007/s11695-018-3553-9).
Abstract
Background: There is a growing interest in comparing the effectiveness and costs of alternative forms of bariatric surgery. We aimed to examine the per-patient, procedural costs of Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and adjustable gastric banding (AGB) in the United Kingdom.
Methods: Multi-centre (two National Health Service; NHS and one private hospital) micro-costing, using a time-and-motion study. Prospective collection of surgery times, staff quantities, equipment, instruments and consumables for 12 patients (four RYGB, five SG, three AGB) from patients’ first surgeon interaction on the day of surgery to departure from the theatre recovery area. Costs were attached to quantities and mean costs compared. Sensitivity and scenario analyses assessed the impact of varying surgery inputs and consideration of additional plausible factors respectively on total costs.
Results: Mean procedural costs were £5002 for RYGB, £4306 for SG and £2527 for AGB. Varying staff seniority or altering procedure times had small impacts on costs (± 4–6%). Reducing prices of consumables by 20% reduced costs by 10–13%. Accounting for differences in surgical technique by altering the number of staple reloads used impacted costs by ± 7–10%. Adjusted total costs from scenario analyses were similar to NHS tariffs for RYGB and SG (difference of £51 and -£119 respectively) but were much lower for AGB (difference of £1982).
Conclusions: These detailed costs will allow for more precise reimbursement of bariatric surgery and support comprehensive assessments of cost-effectiveness. Additional work to investigate costs of post-surgical care, re-operations and life-long support received by patients following surgery is required.
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e-pub ahead of print date: 27 October 2018
Published date: 15 February 2019
Identifiers
Local EPrints ID: 475812
URI: http://eprints.soton.ac.uk/id/eprint/475812
ISSN: 0960-8923
PURE UUID: 461651cb-9fe1-4946-b0d3-fe7f3764dddf
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Date deposited: 28 Mar 2023 18:33
Last modified: 17 Mar 2024 00:12
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Contributors
Author:
Brett Doble
Author:
Richard Welbourn
Author:
Nicholas Carter
Author:
James Byrne
Author:
Chris A Rogers
Author:
J.M. Blazeby
Corporate Author: By-Band-Sleeve Trial Management Group
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