Operational Cost of Obesity Surgery in Turkey

Introduction: Obesity and its comorbidities are among the primary challenges health systems face globally. Obesity is rapidly becoming a problem in Turkey, as well. The real cost of obesity surgery differs from country to country mainly due to differences in the costs of health care services, medical devices and medicines. The objective of this study is to fi nd out the operational cost of obesity surgery in Turkey. Materials and Methods: Expert panel is the main methodology used in the study. An expert panel questionnaire form was designed after the literature review aiming at fi nding the costs. The form was sent to the experts in advance and a panel discussion was undertaken to reach a consensus. After the consensus building phase, the cost of surgical treatment of obesity was estimated based on the public reimbursement and auction price. Results: Laparoscopic by-pass surgery had the highest cost compared to others, in both operational and post-op costs. The highest cost for pre-op was the laparoscopic sleeve operations. The package payment included all costs and services between pre-operative period and 15 days after operation. Based on the analysis, the package reimbursement prices were below their actual costs for all surgical methods. Conclusion: Social Security Institution reimburses the obesity surgery with a fi xed amount of 4500 TL, 3100 TL and 2250 TL for by-pass, sleeve and banding surgeries, respectively. This fi xed amount covers pre-operative, operative and post operative period. It was shown that the fi xed amount is lower than the real cost of the practice of obesity surgery. As a result, hospital managements can avoid performing obesity surgery or reduce the quality of the surgical treatment by lowering possible losses. Decision makers may need to evaluate the results of the study to understand the real picture and to take action in order to improve the obesity surgery reimbursement.