Open Data Available in France: A Great Asset to Study Real-Life Trends for Disease Burden - An Example With Bariatric Surgery Procedures

OBJECTIVES: To highlight strengths and weaknesses of the open data made available from the French National Healthcare Insurance (NHI) and Agence Technique de l’Information en Santé (ATIH) through concrete example describing evolution and costs of bariatric surgery procedures.

METHODS: This work was based on reprocessing of two open databases: OpenCCAM (gathering information on medical procedures realized in hospital setting) and ScanSanté (gathering information of all hospital stays). All procedures related to initial sleeve set up (CCAM codes HFFC018, HFFA011), bypass (HFCC003, HFCA001) and gastric bands (HFMC007, HFMA009) were extracted between 2018 and 2022.

RESULTS: In 2022, 38,991 hospital stays related to initial bariatric surgeries were recorded in France, including 24,853 sleeve gastrectomies, 11,691 bypasses and 650 bands procedures. This overall number tended to decrease since 2018, going from 46,516 hospital stays in 2018 down to 26,876 in 2020. After the COVID19 period, bariatric surgery activity picked up again and the number of hospital stays for bariatric procedures observed in 2022 (37,194) was close to 2019 (38,891). The proportion of overall bariatric surgeries performed as outpatient remained quite low in 2022, except for gastric bands (bypass: 2,3%; sleeve: 3,3%; band: 57,8%). Costs of hospital stays related to these procedures in public hospital can vary from €4,496 for bands procedures, up to €5 138 for a sleeve procedure depending on patient health status and length of stay, with a global burden of sleeve surgeries exceeding €127 million of euros in 2022.

CONCLUSIONS: Bariatric surgeries, especially through sleeve surgeries, continue to generate high costs for the health insurance in France, showing that obesity remains a major public health issue and should not be a neglected disease. This work also demonstrates that open data from the French health insurance can be a strong asset to evaluate trends and related costs of hospital activities in France.