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A qualitative investigation of the health economic impacts of bariatric surgery for obesity and implications for improved practice in health economics

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  • Julie A. Campbell
  • Douglas Ezzy
  • Amanda Neil
  • Martin Hensher
  • Alison Venn
  • Melanie J. Sharman
  • Andrew J. Palmer
Abstract
Obesity is an economic problem. Bariatric surgery is cost‐effective for severe and resistant obesity. Most economic evaluations of bariatric surgery use administrative data and narrowly defined direct medical costs in their quantitative analyses. Demand far outstrips supply for bariatric surgery. Further allocation of health care resources to bariatric surgery (particularly public) could be stimulated by new health economic evidence that supports the provision of bariatric surgery. We postulated that qualitative research methods would elicit important health economic dimensions of bariatric surgery that would typically be omitted from the current economic evaluation framework, nor be reported and therefore not considered by policymakers with sufficient priority. We listened to patients: Focus group data were analysed thematically with software assistance. Key themes were identified inductively through a dialogue between the qualitative data and pre‐existing economic theory (perspective, externalities, and emotional capital). We identified the concept of emotional capital where participants described life‐changing desires to be productive and participate in their communities postoperatively. After self‐funding bariatric surgery, some participants experienced financial distress. We recommend a mixed‐methods approach to the economic evaluation of bariatric surgery. This could be operationalised in health economic model conceptualisation and construction, through to the separate reporting of qualitative results to supplement quantitative results.

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  • Julie A. Campbell & Douglas Ezzy & Amanda Neil & Martin Hensher & Alison Venn & Melanie J. Sharman & Andrew J. Palmer, 2018. "A qualitative investigation of the health economic impacts of bariatric surgery for obesity and implications for improved practice in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1300-1318, August.
    • Handle: RePEc:wly:hlthec:v:27:y:2018:i:8:p:1300-1318
    DOI: 10.1002/hec.3776
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    References listed on IDEAS

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    10. Julie A. Campbell & Martin Hensher & Amanda Neil & Alison Venn & Petr Otahal & Stephen Wilkinson & Andrew J. Palmer, 2018. "An Exploratory Study: A Head-to-Head Comparison of the EQ-5D-5L and AQoL-8D for Long-Term Publicly Waitlisted Bariatric Surgery Patients Before and 3 Months After Bariatric Surgery," PharmacoEconomics - Open, Springer, vol. 2(4), pages 443-458, December.
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    17. Julie A. Campbell & Martin Hensher & Amanda Neil & Alison Venn & Stephen Wilkinson & Andrew J. Palmer, 2018. "An Exploratory Study of Long-Term Publicly Waitlisted Bariatric Surgery Patients’ Quality of Life Before and 1 Year After Bariatric Surgery, and Considerations for Healthcare Planners," PharmacoEconomics - Open, Springer, vol. 2(1), pages 63-76, March.
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    1. Joanna Coast & Cara Bailey & Alastair Canaway & Philip Kinghorn, 2021. "“It is not a scientific number it is just a feeling”: Populating a multi‐dimensional end‐of‐life decision framework using deliberative methods," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1033-1049, May.

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