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Bariatric Surgery

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

International Journal of Obesity volume 45, pages 2205–2213 (2021)Cite this article

Subjects

Abstract

Objectives

To estimate the hospital costs among persons with obesity undergoing bariatric surgery compared with those without bariatric surgery.

Methods

We analysed the UK Biobank Cohort study linked to Hospital Episode Statistics, for all adults with obesity undergoing bariatric surgery at National Health Service hospitals in England, Scotland, or Wales from 2006 to 2017. Surgery patients were matched with controls who did not have bariatric surgery using propensity scores approach with a ratio of up to 1-to-5 by year. Inverse probability of censoring weighting was used to correct for potential informative censoring. Annual and cumulative hospital costs were assessed for the surgery and control groups.

Results

We identified 348 surgical patients (198 gastric bypass, 73 sleeve gastrectomy, 77 gastric banding) during the study period. In total, 324 surgical patients and 1506 matched control participants were included after propensity score matching. Mean 5-year cumulative hospital costs were €11,659 for 348 surgical patients. Compared with controls, surgical patients (n = 324) had significantly higher inpatient expenditures in the surgery year (€7289 vs. €2635, P < 0.001), but lower costs in the subsequent 4 years. The 5-year cumulative costs were €11,176 for surgical patients and €8759 for controls (P = 0.001).

Conclusions

Bariatric surgery significantly increased the inpatient costs in the surgery year, but was associated with decreased costs in the subsequent 4 years. However, any cost savings made up to 4 years were not enough to compensate for the initial surgical expenditure.

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Fig. 1: Flowchart of the study.
Fig. 2: Mean annual and cumulatie inpatient costs over the 5 years.

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Data and code availability

The data that support the findings of this study are available from UK Biobank, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data and codes are however available from the authors upon reasonable request and with permission of UK Biobank.

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Acknowledgements

The research has been conducted using the UK Biobank data under Application number 36623.

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Authors and Affiliations

  1. Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China

    Tingting Wu & Carlos K. H. Wong

  2. Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom

    Koen B. Pouwels, Sarah Wordsworth & Seamus Kent

  3. Department of Bariatric Surgery, Musgrove Park Hospital, Taunton, United Kingdom

    Richard Welbourn

  4. Oxford National Institute for Health Research Biomedical Research Centre, Oxford, United Kingdom

    Sarah Wordsworth

  5. Science Policy and Research, National Institute for Health and Care Excellence, London, United Kingdom

    Seamus Kent

  6. Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China

    Carlos K. H. Wong

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Correspondence to Carlos K. H. Wong.

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Competing interests

This study was funded by the Health and Medical Research Fund Research Fellowship Scheme, Food and Health Bureau, Hong Kong SAR (Ref no. #02160087). No known conflicts of interest relevant to this paper were reported.

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Wu, T., Pouwels, K.B., Welbourn, R. et al. Does bariatric surgery reduce future hospital costs? A propensity score-matched analysis using UK Biobank Study data. Int J Obes 45, 2205–2213 (2021). https://doi.org/10.1038/s41366-021-00887-2

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