Operational cost of obesity surgery in Turkey
Güvenç Koçkaya1, Fatma Betül Yenilmez2, Gülpembe Ergin3, Kağan Atikeler3, Mehtap Tatar4, M. Mahir Özmen5, Mehmet Görgün6, Halil Coşkun7, Halil Alış8, Mustafa Şahin9, Ali Yağız Üresin10, Bilgehan Karadayı11, Adem Ünal11, Olgun Şener11, Mustafa Taşkın121HEPA, Healthcare Economics and Policy Association, Ankara, Turkey2Department of Health Economics, Hacettepe University, Ankara, Turkey
3Polar, Healthcare Economics, Ankara, Turkey
4Department of Health Economics and Administration, Hacettepe University, Ankara, Turkey
5Depatment of General Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
6Department of General Surgery, Tepecik Training and Research Hospital, Izmir, Turkey
7Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
8Department of General Surgery, Sisli Training and Research Hospital, Istanbul, Turkey
9Department of General Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey
10Department of Pharmacology, Faculty of Istanbul Medicine, Istanbul University, Istanbul, Turkey
11Department of Health Technologies Assessments, Directory of Health Research, Ankara, Turkey
12Department of General Surgery, Faculty of Cerrahpasa Medicine, Istanbul University, Istanbul, Turkey
INTRODUCTION: Obesity and its comorbidities are among the primary challenges faced by health systems globally. Obesity is rapidly becoming a problem in Turkey, as well. Real cost of obesity surgery differs from country to country, largely due to differences in costs of health care services, medical devices, and medicines. The objective of this study was to determine operational cost of obesity surgery in Turkey.
METHODS: Expert panel was primary source of data in the study. Following literature review of costs of obesity surgery, questionnaire was designed for expert panel. Form was sent to the experts in advance of panel discussion held to reach consensus. After consensus-building phase, cost of surgical treatment of obesity was estimated based on public reimbursement and auction price.
RESULTS: Laparoscopic by-pass surgery had highest cost among obesity surgeries in both operational and postoperative costs, while laparoscopic sleeve operation had highest preoperative cost. Package payment included all costs and services from preoperative period through 15 days after operation. Based on analysis, package reimbursement prices were below actual costs for all surgical methods.
DISCUSSION AND CONCLUSION: Social Security Institution reimburses cost of obesity surgery at fixed amount of 4500 TL, 3100 TL, and 2250 TL for by-pass, sleeve, and banding surgeries, respectively. This fixed amount includes preoperative, operative, and postoperative periods. It was observed that fixed amount provided is lower than real cost of the practice of obesity surgery. As a result, hospital management may avoid performing obesity surgery or reduce the quality of surgical treatment to reduce losses. Decision makers may need to evaluate results of the study to understand accurate picture and take action in order to improve obesity surgery reimbursement.
Manuscript Language: English