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Robotic Gastric Bypass Surgery in the Swiss Health Care System: Analysis of Hospital Costs and Reimbursement

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Abstract

Background

Robotic technology shows some promising early outcomes indicating potentially improved outcomes particularly for challenging bariatric procedures. Still, health care providers face significant clinical and economic challenges when introducing innovations.

Methods

Prospectively derived administrative cost data of patients who were coded with a primary diagnosis of obesity (ICD-10 code E.66.X), a procedure of gastric bypass surgery (CHOP code 44.3), and a robotic identifier (CHOP codes 00.90.50 or 00.39) during the years 2012 to 2015 was analyzed and compared to the triggered reimbursement for this patient cohort.

Results

A total of 348 patients were identified. The mean number of diagnoses was 2.7 and the mean length of stay was 5.9 days. The overall mean cost per patients was Swiss Francs (CHF) from 2012 to 2014 that was 21,527, with a mean reimbursement of CHF 24,917. Cost of the surgery in 2015 was comparable to the previous years with CHF 22,550.0 (p = 0.6618), but reimbursement decreased significantly to CHF 20,499.0 (0.0001).

Conclusions

The average cost for robotic gastric bypass surgery fell well below the average reimbursement within the Swiss DRG system between 2012 and 2014, and this robotic procedure was a DRG winner for that period. However, the Swiss DRG system has matured over the years with a significant decrease resulting in a deficit for robotic gastric bypass surgery in 2015. This stipulates a discussion as to how health care providers should continue offering robotic gastric bypass surgery, particularly in the light of developing clinical evidence.

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Authors and Affiliations

  1. Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland

    Monika E. Hagen, Minoa K. Jung, Nicolas Amirghasemi, Nicolas C. Buchs, Jassim Fakhro, Leo Buehler & Philippe Morel

  2. Medical controlling, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland

    Peter Rohner

Authors
  1. Monika E. Hagen
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  2. Peter Rohner
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  3. Minoa K. Jung
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  4. Nicolas Amirghasemi
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  5. Nicolas C. Buchs
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  6. Jassim Fakhro
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  7. Leo Buehler
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  8. Philippe Morel
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Corresponding author

Correspondence to Monika E. Hagen.

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Conflict of Interest

Monika E. Hagen received personal fees and non-financial support from Intuitive Surgical Inc., outside this project.

Monika E. Hagen received personal fees from Ethicon Inc., outside this project.

Minoa K. Jung received non-financial support from Intuitive Surgical Inc., outside this project.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Not applicable.

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Hagen, M.E., Rohner, P., Jung, M.K. et al. Robotic Gastric Bypass Surgery in the Swiss Health Care System: Analysis of Hospital Costs and Reimbursement. OBES SURG 27, 2099–2105 (2017). https://doi.org/10.1007/s11695-017-2613-x

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  • DOI: https://doi.org/10.1007/s11695-017-2613-x

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