Objective: The aim of this study is to determine the service cost of bariatric surgery within the scope of diagnosis-based package price payment which is one of the reimbursement methods in Turkey, and to determine to what extent the reimbursement amount specified in the Health Application Notification covers the service cost.

Material and Method: The study is a descriptive and the relevant data were obtained retrospectively. All patients who had bariatric surgery in two university hospitals in Konya/Turkey in 2019 constitute the study population. It was determined that only the services with the P609871 (Obesity, By-pass), P609872 (Obesity, Sleeve) Health Application Notification codes were provided to 70 patients, but the patients who were determined to have different operating codes were excluded from the scope of the study and the study was conducted with 66 patients.

Results: In terms of university hospitals, the income-to- expense ratio for obesity bypass surgery is 48.90%, and 39.19% for obesity sleeve surgery. In general, except for the fixed costs for bariatric surgery, the amount paid by Social Security Agency (SSA) within the scope of Health Application Notification covers approximately 40.05% of the cost of university hospitals. It has been determined that the material cost has the highest share among the cost elements.

Conclusions: As a result of the cost analysis, it was determined that university hospitals made a loss for the relevant services. It has been concluded that the diagnosis- based package price payment method in university hospitals cannot cover the costs and that threatens the financial sustainability of university hospitals serving with Health Application Notification prices.

Cost analysis Obesity surgery Health application communique