Preoperative Follow-up in Bariatric Surgery: Why They Give Up? Rate, Causes, and Economic Impact of Dropout.
Obes Surg
; 33(9): 2652-2657, 2023 09.
Article
in En
| MEDLINE
| ID: mdl-37477831
ABSTRACT
BACKGROUND:
Preoperative attrition is highly prevalent in patients referred for bariatric surgery. Little information is available neither on reasons reported by patients for attrition in knowledge nor costs of attrition in a publicly funded health system.OBJECTIVES:
To assess the reasons for the attrition of bariatric candidates and calculate its economic impact on a population with obesity in a public hospital in France.METHODS:
This is a retrospective study including all bariatric surgery candidates between 2014 and 2018 in our Center of Excellence in Obesity Care. Data were extracted from the hospital information system, and patient-related outcomes were collected via a standardized questionnaire. Economic analysis was performed. Primary outcome was to analyze the rate of preoperative attrition. Secondary outcome was reasons for discontinuation and their economic impact.RESULTS:
In total, 1360 patients were referred for bariatric surgery at our hospital, and 1225 were included in the study. Attrition rate in preoperative phase was 46.8%. Three factors were significantly associated with follow-up fragmentation risk unemployment (OR 0.52, 95% CI 0.29-0.7, p < 0.001), active smoking (OR 2.24, 95% CI 1.53-5.15, p < 0.001), and body mass index (OR 0.98, 95% CI 0.97-1.00, p = 0.036). Average cost to the healthcare system was 792 for each patient who dropped out.CONCLUSIONS:
We identified predictors and patient-reported factors that seem to be beyond the possibility of removal by health professionals. We should consider and address preventable factors, through the development of care pathways tailored to the individual profile of a patient.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Obesity, Morbid
/
Bariatric Surgery
Type of study:
Etiology_studies
/
Guideline
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Obes Surg
Journal subject:
METABOLISMO
Year:
2023
Document type:
Article
Affiliation country:
France