title: Post-bariatric surgery body contouring treatment in the public health system: cost study and perception by patients.
abstract: BACKGROUND
  Post-bariatric, body contouring surgery to treat the sequelae of massive weight loss is an undervalued topic by patients and in most of the literature. The objective of this study was to determine the mean cost per patient of this treatment in a public morbid obesity unit, and compare it with the perception by the patients.
  
  
  METHODS
  Costs were estimated using a specific Diagnosis-Related Group-based method and a questionnaire in a sample of 100 patients who had completed body contouring treatment.
  
  
  RESULTS
  This study included 23 men and 77 women with a mean age of 48.5 years, a mean reduction of body mass index of 20.77 kg/m, and a median follow-up of 58 months. These patients had undergone surgery, as needed, as follows: on the lower part of the trunk (109 operations; mean cost, &OV0556;6348.6), cruroplasty (43 operations; mean cost, &OV0556;3490), brachioplasty (28 operations; mean cost &OV0556;3150), and the upper part of the trunk (10 operations; mean cost, &OV0556;4290). The rate of complications has been high (up to 50 percent) and, although the more severe complications are rare (10.5 percent Clavien grade IIIb), these represent high costs (mean, &OV0556;24462.6). Forty-five patients answered the questionnaire. Although they think that this surgery improves their quality of life, they have undervalued its total cost (17.58 percent; &OV0556;2034) (p = 0.16).
  
  
  CONCLUSIONS
  The average cost of post-bariatric surgery body contouring treatment in this unit is &OV0556;8263.95 (1.66 operations per patient). The severe complications increase by 2.96 times the average cost per patient.
authors.affiliation: Barcelona, Spain From the Plastic Surgery Department and the General and Digestive Surgery Department, Hospital Universitari Germans Trias i Pujol; and the Medicine Faculty, Surgery Department, Universitat Autònoma de Barcelona.
authors.forename: Jordi Vilà
authors.initials: JV
authors.lastname: Poyatos
authors.forename: José María Balibrea
authors.initials: JMB
authors.lastname: Del Castillo
authors.forename: Benjamí Oller
authors.initials: BO
authors.lastname: Sales
authors.forename: Antonio Alastrué
authors.initials: AA
authors.lastname: Vidal
mesh_terms: D061645:Abdominoplasty / Q000191:economics*; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D009767:Obesity, Morbid / Q000191:economics / Q000601:surgery*; D017060:Patient Satisfaction; D011788:Quality of Life; D013030:Spain; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss