OBJECTIVE
The purpose of this study was to evaluate the economic efficiency of using surgical tactics for the treatment of obesity at the expense of the healthcare system of the Russian Federation.
MATERIAL AND METHODS
An analysis of the impact on the budget was carried out, within which the costs of the healthcare system for providing care to obese patients were modeled in the event of an increase in the proportion of people who underwent bariatric interventions. The data obtained in the framework of a previously conducted case—control study (A. Aminian et al., 2019) regarding the achievement of clinical outcomes in the group of conservative and surgical management of patients were selected as information on the effectiveness. Direct medical costs are taken into account. Annual 5% cost discounting has been applied.
RESULTS
The total cost per 1 patient for 8 years in the surgical treatment group is 1.109.407 rubles, in the conservative treatment group — 1.242.501 rubles. The total difference in costs per 1 patient over 8 years is 133.093 rubles in favor of a group of operated patients, which does not cover the costs associated with surgical intervention in case of reimbursement of costs at the expense of the healthcare system. The increase in costs in all variants of the simulated practice for the entire simulated population of obese patients in the Russian Federation over an 8-year period amounted to no more than 0.068% of the costs of the healthcare system. The minimum increase (0.03% of all costs) was a variant of practice, when about 6.000 surgical interventions are performed annually at the personal expense of patients and another 1.000 at the expense of the budget of the healthcare system.
CONCLUSIONS
Currently, about 1.5 million people in the Russian Federation need surgical treatment for obesity, while in real practice access to this type of medical care is extremely limited. The results of this study can be used as support in decision-making on the development of a comprehensive national strategy for financing medical care for patients with obesity and related diseases.
