Operational cost of obesity surgery in 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.