Objectives: Morbid Obesity is a prevalent condition in 3,2% of Chileans. Bariatric Surgery (BS) is suggested as a therapy for eligible patients, however, its prioritization in Chile has been partial and insufficient. A Case Study was conducted to determine supply-side and financing gaps in Bariatric Surgery in Chile from the public payor perspective.

Methods: A case study was carried out. The National Health Survey was explored to obtain demand-side estimates of eligible patients. A three-dimension survey, piloted in a panel of experts, was applied to five eligible public providers (PP) participants of the network for BS in different Regions. For triangulation, Diagnosis-Related Groups (DRGs) information was retrieved and analyzed to explore execution and financial status. Out of all these sources the Explicit Current Productivity (ECP), Real Productivity (RP) and Maximum Mean Expected Productivity (MMEP) was obtained. For the MMEP, the Leontief fixed-proportion model was applied. Financing gaps were measured according to Explicit Current Financing (ECF), Implicit Financing (IF) and Total Current Financing (TCF), ECP, RP and MMEP. A model of incidence per subgroups was utilized to determine cohorts entering demand-side stock.

Results: Current ECP of BS is 467 quotas nationally, however RP raises at 1,291 quotas estimated by DGRs. The MMEP was estimated in 6,499, based on PP supply-capabilities against a demand-excess of 19,461 cases/year in a 10-year horizon. ECF was found to be $1,821 (billion CLP), however, IF adds $3,221. The TCF was $5,042 (2,77 times CEF). The incremental expenditure for solving the gap between RP and MMEP supply-side gap is $20,311/year.

Conclusion: CEF was 14,34% higher than the payors’ cap. TCF implies an effort of PP in the financing of cases outside of DRGs by IF. The financing gap to solve MMEP in BS would be similar to prioritized diseases (brain carcinoma, cardiac stenosis, etc.). Supply-side gaps in BS reach 19,461 cases/year.