The Alberta population-based prospective evaluation of the quality of life outcomes and economic impact of bariatric surgery (APPLES) study: background, design and rationale
Open Access
- 8 October 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Health Services Research
- Vol. 10 (1), 284
- https://doi.org/10.1186/1472-6963-10-284
Abstract
Extreme obesity affects nearly 8% of Canadians, and is debilitating, costly and ultimately lethal. Bariatric surgery is currently the most effective treatment available; is associated with reductions in morbidity/mortality, improvements in quality of life; and appears cost-effective. However, current demand for surgery in Canada outstrips capacity by at least 1000-fold, causing exponential increases in already protracted, multi-year wait-times. The objectives and hypotheses of this study were as follows: 1. To serially assess the clinical, economic and humanistic outcomes in patients wait-listed for bariatric care over a 2-year period. We hypothesize deterioration in these outcomes over time; 2. To determine the clinical effectiveness and changes in quality of life associated with modern bariatric procedures compared with medically treated and wait-listed controls over 2 years. We hypothesize that surgery will markedly reduce weight, decrease the need for unplanned medical care, and increase quality of life; 3. To conduct a 3-year (1 year retrospective and 2 year prospective) economic assessment of bariatric surgery compared to medical and wait-listed controls from the societal, public payor, and health-care payor perspectives. We hypothesize that lower indirect, out of pocket and productivity costs will offset increased direct health-care costs resulting in lower total costs for bariatric surgery.Keywords
This publication has 53 references indexed in Scilit:
- Health Outcomes of Gastric Bypass Patients Compared to Nonsurgical, Nonintervened Severely ObeseObesity, 2010
- Overview of the Alberta Kidney Disease NetworkBMC Nephrology, 2009
- Treating severe obesity: morbid weights and morbid waitsCMAJ : Canadian Medical Association Journal, 2009
- Cost-Effectiveness of Surgically Induced Weight Loss for the Management of Type 2 Diabetes: Modeled Lifetime AnalysisDiabetes Care, 2009
- Toward the Rational and Equitable Use of Bariatric SurgeryJAMA, 2007
- Long-Term Mortality after Gastric Bypass SurgeryThe New England Journal of Medicine, 2007
- Effects of Bariatric Surgery on Mortality in Swedish Obese SubjectsThe New England Journal of Medicine, 2007
- Prevalence of class I, II and III obesity in CanadaCMAJ : Canadian Medical Association Journal, 2006
- The Costs of Obesity among Full-Time EmployeesAmerican Journal of Health Promotion, 2005
- Smearing Estimate: A Nonparametric Retransformation MethodJournal of the American Statistical Association, 1983