ABSTRACT

Laparoscopic sleeve gastrectomy (LSG) is an easy and safe surgical procedure with effective results. The cost of an LSG surgery can be influenced by many parameters and the medical supplies used. In this study, we aimed to determine the parameters affecting the cost of this procedure and whether it is a cost-effective procedure for hospitals.

Laparoscopic sleeve gastrectomy performed in a public hospital during 2016 were retrospectively reviewed. Parameters such as age, sex, body mass index, the length of hospitalization, the postoperative need for a follow-up in an intensive care unit (ICU), and the presence of complications were determined. In addition, all expensive items incurred during LSG procedure, their costs, and the amount of invoicing for the Social Insurance Institution were determined. The patients whose procedural costs and invoiced amounts exceeded 80 percentiles constituted an increased cost and increased billing group, and those under 80 percentile constituted a normal cost and normal billing group. The parameters were compared between the increased and normal groups.

A total of 121 patients (10 males and 111 females) were included in the study. The mean age was 38.7 years, and the mean body mass index was 47.6 kg/m². There were 95 patients in the normal cost group, 26 in the increased cost group, 96 in the normal billing amount group, and 25 in the increased bill amount group. It was found that seven complicated patients were in the increased bill amount group, and six of seven were also in the increased cost group (p=0.001). In the increased bill amount and increased cost groups, the length of hospitalization was 14.3±19.7 and 14.4±19.7 days, respectively (p=0.001). There was no significant difference between the groups in terms of age, sex, body mass index, and ICU need (p>0.05).

The development of complications after LSG and the increased length of hospitalization increase the procedural cost. There is no correlation between cost increase and patient variables. Therefore, the factors affecting cost increase should be considered as unpredictable conditions

Keywords: Obesity, laparoscopic sleeve gastrectomy, cost analysis