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Preoperative Follow-up in Bariatric Surgery: Why They Give Up? Rate, Causes, and Economic Impact of Dropout.
Paolino, Luca; Le Fouler, Adrien; Epaud, Salomé; Bathaei, Sarah; Mokhtari, Nawel; Lazzati, Andrea.
Afiliación
  • Paolino L; Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000, Créteil, France.
  • Le Fouler A; Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000, Créteil, France. adrien.lefouler@gmail.com.
  • Epaud S; Kaduceo SAS, 96 Avenue Jules Julien, 31400, Toulouse, France.
  • Bathaei S; Nutrition Unit, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000, Créteil, France.
  • Mokhtari N; Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000, Créteil, France.
  • Lazzati A; Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000, Créteil, France.
Obes Surg ; 33(9): 2652-2657, 2023 09.
Article en En | MEDLINE | ID: mdl-37477831
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Cirugía Bariátrica Tipo de estudio: Etiology_studies / Guideline / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Cirugía Bariátrica Tipo de estudio: Etiology_studies / Guideline / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos