The effect of bariatric surgery on health care costs: A synthetic control approach using Bayesian structural time series.

Published on Sep 5, 2019in Health Economics2.027
· DOI :10.1002/HEC.3941
Christoph Kurz4
Estimated H-index: 4
Martin Rehm + 3 AuthorsLarissa Schwarzkopf8
Estimated H-index: 8
: Surgical measures to combat obesity are very effective in terms of weight loss, recovery from diabetes, and improvement in cardiovascular risk factors. However, previous studies found both positive and negative results regarding the effect of bariatric surgery on health care utilization. Using claims data from the largest health insurance provider in Germany, we estimated the causal effect of bariatric surgery on health care costs in a time period ranging from 2 years before to 3 years after bariatric intervention. Owing to the absence of a control group, we employed a Bayesian structural forecasting model to construct a synthetic control. We observed a decrease in medication and physician expenditures after bariatric surgery, whereas hospital expenditures increased in the post-intervention period. Overall, we found a slight increase in total costs after bariatric surgery, but our estimates include a high degree of uncertainty.
  • References (56)
  • Citations (0)
📖 Papers frequently viewed together
4 Authors (H.A. Cabra, ..., S. Rodriguez)
2 Citations
71 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Kayoko ShiodaH-Index: 8
#2Cynthia Schuck-PaimH-Index: 18
Last. Daniel M. WeinbergerH-Index: 23
view all 7 authors...
Background:The synthetic control model is a powerful tool to quantify the population-level impact of vaccines because it can adjust for trends unrelated to vaccination using a composite of control diseases. Because vaccine impact studies are often conducted using smaller, subnational datasets, we ev
1 CitationsSource
#1Frank de Vocht (UoB: University of Bristol)H-Index: 24
Abstract This study assesses whether temporal trends in glioblastoma multiforme (GBM) in different brain regions, and of different malignant and benign (including acoustic neuroma and meningioma) subtypes in the temporal lobe, could be associated with mobile phone use. Annual 1985–2005 incidence of brain cancer subtypes for England were linked to population-level covariates. Bayesian structural timeseries were used to create 2006–2014 counterfactual trends, and differences with measured newly di...
2 CitationsSource
#1Tiago M. FragosoH-Index: 1
#2Wesley BertoliH-Index: 1
Last. Francisco Louzada (CSIC: Spanish National Research Council)H-Index: 16
view all 3 authors...
Bayesian model averaging (BMA) provides a coherent and systematic mechanism for accounting for model uncertainty. It can be regarded as an direct application of Bayesian inference to the problem of model selection, combined estimation and prediction. BMA produces a straightforward model choice criterion and less risky predictions. However, the application of BMA is not always straightforward, leading to diverse assumptions and situational choices on its different aspects. Despite the widespread ...
41 CitationsSource
#1Aurélia Lépine (Lond: University of London)H-Index: 6
#2Mylene Lagarde (Lond: University of London)H-Index: 20
Last. Alexis Le Nestour (University of Otago)H-Index: 3
view all 3 authors...
Despite its high political interest, the impact of removing user charges for health care in low-income settings remains a debatable issue. We try to clear up this contentious issue by estimating the short-term effects of a policy change that occurred in 2006 in Zambia, when 54 of 72 districts removed fees. We use a pooled synthetic control method in order to estimate the causal impact of the policy on health care use, the provider chosen, and out-of-pocket medical expenses. We find no evidence t...
4 CitationsSource
Last. Jøran Hjelmesæth (University of Oslo)H-Index: 15
view all 8 authors...
Importance The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data fr...
44 CitationsSource
#1Tatiana Marschik (University of Veterinary Medicine Vienna)H-Index: 1
#2W. Obritzhauser (University of Veterinary Medicine Vienna)H-Index: 9
Last. Beate Pinior (University of Veterinary Medicine Vienna)H-Index: 9
view all 8 authors...
• A cost-benefit analysis of the Styrian bovine viral diarrhoea virus (BVDV) control and eradication programme was conducted.
8 CitationsSource
#1Susan Athey (Stanford University)H-Index: 40
#2Guido W. Imbens (Stanford University)H-Index: 66
In this paper we discuss recent developments in econometrics that we view as important for empirical researchers working on policy evaluation questions. We focus on three main areas, where in each case we highlight recommendations for applied work. First, we discuss new research on identification strategies in program evaluation, with particular focus on synthetic control methods, regression discontinuity, external validity, and the causal interpretation of regression methods. Second, we discuss...
164 CitationsSource
#1Nichola YatesH-Index: 1
Last. Silke B. WolfenstetterH-Index: 11
view all 9 authors...
Objective: To estimate the excess costs of obese compared to normal-weight persons in Germany based on self-reported resource utilisation and work absence.
12 CitationsSource
#1Noemi Kreif (Lond: University of London)H-Index: 12
#2Richard Grieve (Lond: University of London)H-Index: 32
Last. Matt Sutton (University of Manchester)H-Index: 37
view all 6 authors...
This paper examines the synthetic control method in contrast to commonly used difference-in-differences (DiD) estimation, in the context of a re-evaluation of a pay-for-performance (P4P) initiative, the Advancing Quality scheme. The synthetic control method aims to estimate treatment effects by constructing a weighted combination of control units, which represents what the treated group would have experienced in the absence of receiving the treatment. While DiD estimation assumes that the effect...
49 CitationsSource
In a seminal paper Abadie et al (2010) develop the synthetic control procedure for estimating the effect of a treatment, in the presence of a single treated unit and a number of control units, with pre-treatment outcomes observed for all units. The method constructs a set of weights such that covariates and pre-treatment outcomes of the treated unit are approximately matched by a weighted average of control units. The weights are restricted to be nonnegative and sum to one, which allows the proc...
34 Citations
Cited By0