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Original article
Effectiveness and efficiency of a special program to reduce the bariatric surgery waiting list at a tertiary hospital
Eficacia y eficiencia de un programa especial para la disminución de la lista de espera de cirugía bariátrica en un hospital terciario
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Gabriel Kraus-Fischera, Raquel Alfonso-Ballestera,b, Isabel Mora-Olivera, Norberto Cassinello-Fernándeza,b, Joaquín Ortega-Serranoa,b,
Corresponding author
joaquin.ortega@uv.es

Corresponding author.
a Unidad de Cirugía Endocrina y Bariátrica, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Valencia, Valencia, Spain
b Departamento de Cirugía, Universidad de Valencia, Valencia, Spain
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Received 29 April 2020. Accepted 30 May 2020
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Tables (3)
Table 1. Preoperative characteristics of the 2 groups.
Table 2. Perioperative parameters.
Table 3. Costs per patient (€).
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Abstract
Introduction

Bariatric surgery is one of the most common surgical practices in Spain. However, this procedure currently has longest delay on surgical waiting lists (SWL). We have developed a special surgical program that aims to reduce this waiting list and to assess the economic and clinical repercussions in a high-volume bariatric surgery unit.

Methods

A three-month prospective study was carried out comparing outcomes, results and perioperative resources consumed for 45 patients who underwent bariatric surgery. The patients were divided into 2 groups: patients who underwent the standard procedure in the operating room, and patients treated in the special program. Epidemiological, healthcare and economic factors were taken into account.

Results

Two homogeneous groups of patients were operated on, successfully reducing the SWL. Morbidity was similar in both groups and the average cost of the surgeries performed was €5,331.40; in the standard group, the cost was €5,372.50±€798.10, and the cost of the special program group was €5,290.30±€685.10, with no significant differences.

Conclusions

In hospitals with a high volume of bariatric surgery, it is feasible to incorporate special surgical programs that are able to reduce surgical waiting lists, while maintaining quality criteria and without incurring a greater expense to the healthcare system.

Keywords:
Bariatric surgery
Costs and cost analysis
Waiting lists
Public health
Resumen
Introducción

La cirugía bariátrica es uno de los procedimientos quirúrgicos más realizados en España, sin embargo actualmente es la cirugía con mayor demora en la lista de espera quirúrgica (LEQ). Para disminuir la LEQ se pone en marcha un programa especial de autoconcertación, y se quiere valorar su utilidad, estudiando las repercusiones clínicas y económicas en una unidad de alto volumen de cirugía bariátrica.

Métodos

Se realizó un estudio prospectivo de 3 meses comparando evolución, resultados y consumo de recursos perioperatorios de 45 pacientes operados de cirugía bariátrica, divididos en 2 grupos, pacientes operados en quirófano de forma estándar y pacientes operados en programación especial. Se tuvieron en cuenta factores epidemiológicos, asistenciales y económicos.

Resultados

Se operaron 2 grupos homogéneos de pacientes, reduciendo con éxito la LEQ. La morbilidad fue similar en ambos grupos y el coste medio de las cirugías realizadas fue de 5.331,4euros, 5372,5±798,1euros para el grupo estándar y 5.290,3±685,1euros para el grupo de programación especial, sin diferencias significativas.

Conclusiones

En centros hospitalarios donde se realiza alto volumen de cirugía bariátrica es factible incorporar programas especiales quirúrgicos que permiten la reducción en la demora de las listas de espera quirúrgica, manteniendo los criterios de calidad y sin suponer un mayor gasto al sistema sanitario.

Palabras clave:
Cirugía bariátrica
Coste y análisis de costes
Listas de espera
Salud pública

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