Cost Analysis of Bariatric Surgery in an Employee-based Healthcare System Following Surgery Coverage
Condition: Morbid Obesity
MeSH terms: Obesity, Morbid
Study type: Observational

Summary: 
      The overall purpose of the study is to determine prospectively the cost effectiveness of
      bariatric surgery following partial coverage by a large healthcare system.
    

Detailed description: 
      Epidemiological studies show that the incidence of morbid obesity is increasing at a
      considerably greater rate than any other obesity category. The National Institutes of Health,
      along with a number of medical and scientific national and international professional
      organizations, recognize that bariatric surgery is the only long-term effective treatment for
      individuals with morbid obesity. Along with massive and sustained weight loss, bariatric
      surgery resolves/improves obesity co-morbidities (type 2 diabetes, hypertension,
      cardiovascular disease, fatty liver disease, asthma, osteoarthritis, fatty liver disease,
      obstructive sleep apnea, dyslipidemia, hyperlipidemia, infertility, depression, cancer risk,
      fertility, and more) and significantly increases longevity.

      Despite the well-documented benefits of bariatric surgery in terms of health and healthcare
      costs, many insurers deny coverage for the surgery out of fear that the cost of surgery will
      financially burden the system. These insurers, however, fail to consider the improvement in
      obesity-related diseases and associated cost savings. The recent change in policy by the
      Florida Hospital Healthcare System (FHHS) that allows for partial coverage of bariatric
      surgery provides the unique opportunity to study prospectively the cost effectiveness of the
      surgery, i.e. cost of surgery vs. cost savings. Study participants will include approximately
      75 to 100 FHHS covered individuals (18 to 64 years) who have been approved for bariatric
      surgery and who have provided their written consent for study participation.

      The study protocol will include a review of patient insurance records for cost analysis of
      medication and medical expenses prior to surgery and over a two-year period postoperatively.
      Patients will also be asked to consent to the completion of a yearly questionnaire concerning
      the status of their obesity co-morbidities, medication use and dosage, and sick leave. The
      outcome of this prospective study will allow for assessment of the costs of surgery, cost
      saving in terms of medication and medical expenses, and the potential time period required
      for return on investment. Such data, when shared with others through peer-review journal
      publications, may assist other employee healthcare systems in their decision to provide
      coverage for bariatric procedures.
    

Observational model: Ecologic or Community
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Study subjects will include any individual having been approved for surgery that consents
        to the review of their records and additional survey information pertaining to medication
        use, dosage, anthropometrics and medical-related days taken. Study subjects would include
        male and female gender, all ethnicities, ages 18 to 65 years, and exclude populations who
        do not meet the criteria for bariatric surgery