Clinical Indications, Utilization, and Funding of Bariatric Surgery in EuropeReportar como inadecuado

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Obesity Surgery

, Volume 25, Issue 8, pp 1408–1416

First Online: 21 December 2014


PurposeThe objective of this study was to evaluate the current utilization, the level of endorsement by professional societies, and health technology assessment bodies, as well as the reimbursement levels for bariatric surgery in European countries.

Materials and MethodsWe performed an analysis of the indications for bariatric surgery based on national clinical and commissioning guidelines, current utilization of surgery, characteristics of patients who underwent surgery, and reimbursement tariffs in Belgium, Denmark, England, France, Germany, Italy, and Sweden. Data were obtained from national patient registries, administrative databases, and published literature for the year 2012.

ResultsDespite clear consensus outlined in clinical guidelines, significant differences were found in the eligibility criteria for surgery. Patients with no significant comorbidities were deemed eligible if they had a body mass index BMI of 40 or 50 kg-m in Denmark. Irrespective of the country, patients with comorbidities were eligible if they had a BMI of 35 kg-m. The highest utilization of bariatric surgery number of surgeries per 1 M population was observed in Belgium 928, Sweden 761, and France 571 while Italy 128, England 117, and Germany 72 had the lowest utilization. There was a strong negative correlation between utilization and average BMI level of the patient population r = −.909, p = 0.005. The annual per capita spending on surgery differed significantly between countries, ranging from €0.54 in Germany to €4.33 in Belgium.

ConclusionsThere are significant variations in the clinical indications, utilization, and funding of bariatric surgery in European countries.

KeywordsBariatric surgery Clinical indication Reimbursement Utilization Health care policy Electronic supplementary materialThe online version of this article doi:10.1007-s11695-014-1537-y contains supplementary material, which is available to authorized users.

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Autor: Oleg Borisenko - Zeynep Colpan - Bruno Dillemans - Peter Funch-Jensen - Jan Hedenbro - Ahmed R. Ahmed


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