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A qualitative investigation of the health economic impacts of bariatric surgery for obesity and implications for improved practice in health economics


Campbell, JA and Ezzy, D and Neil, A and Hensher, M and Venn, A and Sharman, MJ and Palmer, AJ, A qualitative investigation of the health economic impacts of bariatric surgery for obesity and implications for improved practice in health economics, Health Economics, 27, (8) pp. 1300-1318. ISSN 1057-9230 (2018) [Refereed Article]

Copyright Statement

2018 John Wiley & Sons, Ltd.

DOI: doi:10.1002/hec.3776


Obesity is an economic problem. Bariatric surgery is cost‐effective for severe and resistant obesity. Most economic evaluations of bariatric surgery use administrative data and narrowly defined direct medical costs in their quantitative analyses. Demand far outstrips supply for bariatric surgery. Further allocation of health care resources to bariatric surgery (particularly public) could be stimulated by new health economic evidence that supports the provision of bariatric surgery. We postulated that qualitative research methods would elicit important health economic dimensions of bariatric surgery that would typically be omitted from the current economic evaluation framework, nor be reported and therefore not considered by policymakers with sufficient priority. We listened to patients: Focus group data were analysed thematically with software assistance. Key themes were identified inductively through a dialogue between the qualitative data and pre‐existing economic theory (perspective, externalities, and emotional capital). We identified the concept of emotional capital where participants described life‐changing desires to be productive and participate in their communities postoperatively. After self‐funding bariatric surgery, some participants experienced financial distress. We recommend a mixed‐methods approach to the economic evaluation of bariatric surgery. This could be operationalised in health economic model conceptualisation and construction, through to the separate reporting of qualitative results to supplement quantitative results.

Item Details

Item Type:Refereed Article
Keywords:bariatric surgery, qualitative research, economic evaluation, emotional capital, human capital, out-of-pocket costs, weight loss surgery
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Campbell, JA (Dr Julie Campbell)
UTAS Author:Ezzy, D (Professor Douglas Ezzy)
UTAS Author:Neil, A (Associate Professor Amanda Neil)
UTAS Author:Venn, A (Professor Alison Venn)
UTAS Author:Sharman, MJ (Dr Melanie Sharman)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:126279
Year Published:2018
Funding Support:National Health and Medical Research Council (1076899)
Web of Science® Times Cited:6
Deposited By:Office of the School of Social Sciences
Deposited On:2018-06-02
Last Modified:2019-01-07

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