Obesity Surgery

, Volume 21, Issue 5, pp 644–649

A Cost–Benefit Analysis of Bariatric Surgery on the South Plains Region of Texas

  • Bradley T. Ewing
  • Mark A. Thompson
  • Mitchell S. Wachtel
  • Eldo E. Frezza
Economic Aspects

Abstract

The regional economic burdens of obesity have not been fully quantified. This study incorporated bariatric surgery demographics collected from a large university hospital with regional economic and employment data to evaluate the cost of obesity for the South Plains region of Texas. Data were collected from patients who underwent laparoscopic gastric bypass and laparoscopic banding between September 2003 and September 2005 at Texas Tech University Health Sciences Center. A regional economic model estimated the economic impact of lost productivity due to obesity. Comparisons of lost work days in the year before and after surgery were used to estimate the potential benefit of bariatric surgery to the South Plains economy. Total output impacts of obesity, over $364 million, were 3.3% of total personal income; total labor income impacts neared $60 million: the losses corresponded to $2,389 lost output and $390 lost labor income per household. Obesity cost the South Plains over 1,977 jobs and decreased indirect business tax revenues by over $13 million. The net benefit of bariatric surgery was estimated at $9.9 billion for a discount rate of 3%, $5.0 billion for a discount rate of 5%, and $1.3 billion for a discount rate of 10%. Potential benefits to the South Plains economy of performing bariatric surgery more than outweigh its costs.

Keywords

Obesity Regional economy Lost productivity Economic loss Economic impact 

References

  1. 1.
    Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2000. JAMA. 2002;288:1723–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med. 2003;348:1625–38.PubMedCrossRefGoogle Scholar
  3. 3.
    Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. JAMA. 1999;282:1523–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Swinburn B, Ashton T, Gillespie J, et al. Health care costs of obesity in New Zealand. Int J Obes. 1997;21:891–6.CrossRefGoogle Scholar
  5. 5.
    Thompson D, Edelsberg J, Colditz GA, et al. Lifetime health and economic consequences of obesity. Arch Intern Med. 1999;159:2177–83.PubMedCrossRefGoogle Scholar
  6. 6.
    Thompson D, Wolf AM. The medical-care cost burden of obesity. Obes Rev. 2001;2:189–97.PubMedCrossRefGoogle Scholar
  7. 7.
    Wang G, Zheng ZJ, Heath G, et al. Economic burden of cardiovascular disease associated with excess body weight in U.S. adults. Am J Prev Med. 2002;23:1–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Weintraub M. Long-term weight control study conclusions. Clin Pharmocol Ther. 1992;51:642–6.CrossRefGoogle Scholar
  9. 9.
    Frezza EE, Wachtel MS, Ewing BT. The impact of morbid obesity on the state economy: an initial evaluation. Surg Obes Reat Dis. 2006;2(5):504–8.CrossRefGoogle Scholar
  10. 10.
    Colditz GA. Economic costs of obesity and inactivity. Med Sci Sports Exerc. 1999;31 Suppl 11:S663–7.PubMedGoogle Scholar
  11. 11.
    Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y—500 patients: technique and results, with 3–60 month follow up. Obes Surg. 2000;10:233–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Wolf AM. What is the economic case for treating obesity? Obes Res. 1998;6 Suppl 1:2S–7.PubMedGoogle Scholar
  13. 13.
    Strum R. Increases in clinically severe obesity in the United States, 1986–2000. Arch Surg. 2003;163:2146–8.Google Scholar
  14. 14.
    Sturm R. The effects of obesity, smoking, and drinking on medical problems and cost outranks both smoking and drinking in its deleterious effects on health and health costs. Health Aff (Millwood). 2002;21(2):245–53.CrossRefGoogle Scholar
  15. 15.
    Finkelstein EA, Fiebelkom IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who’s paying? Health Aff (Millwood). 2003;Jan–Jun(Suppl Web exclusives):W3-219-26.Google Scholar
  16. 16.
    Thompson D, Edelsberg J, Kinsey KL, et al. Estimated economic costs of obesity on business. Am J Health Promot. 1998;13:120–7.PubMedGoogle Scholar
  17. 17.
    Thorpe KE, Florence CS, Howard DH, et al. The impact of obesity on rising medical spending. Health Aff (Millwood). 2004;July–Dec(suppl Web exclusives):W4-48-0-86.Google Scholar
  18. 18.
    Tucker LA, Friedman GM. Obesity and absenteeism: an epidemiologic study of 10,825 employed adults. Am J Health Promot. 1998;12:202–7.PubMedGoogle Scholar
  19. 19.
    van Gemert WG, Adang EM, Kop M, et al. A prospective effectiveness analysis of vertical banded gastroplasty for the treatment of morbid obesity. Obes Surg. 1999;9:484–91.PubMedCrossRefGoogle Scholar
  20. 20.
    Craig BM, Tseng DS. Cost-effectiveness of gastric bypass for severe obesity. Am J Med. 2002;113:491–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Clegg A, Colquitt J, Sidhu M, et al. Clinical and cost effectiveness of morbid obesity: a systematic review and economical evaluation. Int J Obes Relat Metab Disord. 2003;27:1167–77.PubMedCrossRefGoogle Scholar
  22. 22.
    Olson D, Lindall S. IMPLAN user’s guide. Stillwater: Minnesota IMPLAN Group; 2002.Google Scholar
  23. 23.
    Bedzek RH, Wendling RM. Fuel efficiency and the economy. Am Sci. 2005;93:132–9.Google Scholar
  24. 24.
    Bureau of Labor Statistics. Employment and earnings. Washington, DC: Bureau of Labor Statistics; 2006. Table 46.Google Scholar
  25. 25.
    American Society for Metabolic and Bariatric Surgery. Fact sheet—metabolic and bariatric surgery. Gainesville: American Society for Metabolic and Bariatric Surgery; 2007.Google Scholar
  26. 26.
    Eschbach K. Texas Health Institute, appendix to the executive summary, findings about the obesity epidemic in Texas, Methodology statement and data tables by county. January 2009.Google Scholar
  27. 27.
    Flood V, Webb K, Lazarus R, et al. Use of self-report to monitor overweight and obesity in populations: some issues for consideration. Aust NZ J Public Health. 2007;24:96–9.CrossRefGoogle Scholar
  28. 28.
    Frezza EE, Wachtel MS, Ewing BT. Bariatric surgery costs and implications for hospital margins: comparing laparoscopic gastric bypass and laparoscopic gastric banding. Surg Laparosc Endosc Percutan Tech. 2007;17:239–44.PubMedCrossRefGoogle Scholar
  29. 29.
    Fisher BL, Schauer P. Medical and surgical options in the treatment of severe obesity. Am J Surg. 2002;184:S9.CrossRefGoogle Scholar
  30. 30.
    Flum DR, Salem L, Elrod JA, et al. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005;294(15):1903–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Finkelstein MM. Obesity, cigarette smoking and the cost of physicians’ services in Ontario. Can J Public Health. 2001;92:437–40.PubMedGoogle Scholar
  32. 32.
    Sampalis JS, Liberman M, Auger S, et al. Impact of weight reduction health-care costs in morbidly obese patients. Obes Surg. 2004;14:939–47.PubMedCrossRefGoogle Scholar
  33. 33.
    Finkelstein EA, Brown DS. A cost-benefit simulation model of coverage for bariatric surgery among full-time employees. Am J Manag Care. 2005;11:641–6.PubMedGoogle Scholar
  34. 34.
    Frezza EE, Wachtel MS, Ewing BT. Economic considerations for bariatric surgery and morbid obesity. ClinicoEconomics and Outcomes Research. 2009;1:1–5.Google Scholar

Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Bradley T. Ewing
    • 1
  • Mark A. Thompson
    • 2
  • Mitchell S. Wachtel
    • 3
  • Eldo E. Frezza
    • 4
  1. 1.Rawls College of BusinessTexas Tech UniversityLubbockUSA
  2. 2.Health Organization Management Program Rawls College of BusinessTexas Tech UniversityLubbockUSA
  3. 3.Department of PathologyTexas Tech University Health Sciences CenterLubbockUSA
  4. 4.University of Surgery, Clinical Research TexasHarlingenUSA

Personalised recommendations