Pre op Post op. Oral. Hypoglycaemics. (OHG's). 52% (31) 13% (8). Insulin. 25% (15) 8% (5). Insulin + OHG's. 20% (12) 2%
Introduction • • •
Health improvement in metabolic diseases after bariatric surgery, including Type 2 Diabetes, is well documented, yet the cost implications have not been fully quantified We aimed to calculate the financial advantages to the local health economy from our centre over a 3 year period
Methods
Results 1
• Collected data from EZ-Notes system on 140 patients after bariatric surgery from June 12 – January 16 • Estimated remaining life years calculated per patient • Estimated annual diabetic care costs (Diabetes UK) used to approximate savings (1); • In-patient care: £1800£2500 per patient per year • Out-patient care: £300£370 per patient per year
• 100% met National Institute for Health and Clinical Excellence (NICE) criteria for surgery (2) • Average excess weight loss (%) at 12 months for all patients was 63% • 60 type 2 diabetes patients (43%) Pre op
Results 2 • Estimated average remaining life years per patient – 33 years (average age 48) (3) • Estimated savings for 44 patients off treatment (1); • Inpatient care: £2,613,600 £3,630,000 • Outpatient care: £435,600 – £537,240
Post op
Oral Hypoglycaemics (OHG’s)
52% (31)
13% (8)
Insulin
25% (15)
8% (5)
Insulin + OHG’s
20% (12)
2% (1)
Diet
3% (2)
3% (2)
No treatment
0% (0)
73% (44)
HBA1C
70
50
Conclusions • >70% of Type 2 diabetic patients “cured” after bariatric surgery • Significant cost savings to local health economy, up to £94, 710 per remaining patient lifetime • Significant improvement in HBA1C post op (Paired T test p value 0.000000389)
Contact Details: Samantha Chambers Upper GI Surgery Worcester Royal Hospital
[email protected]
References 1. Panos Kanavos, Stacey van den Aardweg and Willemien Schurer. 2012. Diabetes expenditure, burden of disease and management in 5 EU countries. London School of Economics (LSE). Cited by Diabetes UK. Available from: www.diabetes.co.uk/cost-of-diabetes.html 2. Obesity: identification, assessment and management NICE guidelines [CG189]. 2014. NICE. Section 1.10 Surgical Interventions Available from: https://www.nice.org.uk/guidance/ cg189/chapter/1-recommendations#surgical-interventions 3. Office for National Statistics. 2015. National Life Tables, United Kingdom; 2012-2014. Available from: www.ons.gov.uk/peoplepopulationandcommunity/birthdsdeathsandmarriages/ lifeexpectancies/bulletins/nationallifetablesunitedkingdom/2015-09-23/pdf
