Cost of surgery in a low-income setting in eastern Uganda

Löfgren, Jenny; Mulowooza, Jude; Nordin, Pär; Wladis, Andreas; Forsberg, Birger C

doi:10.1016/j.surg.2015.01.026

Cited by 20 publications

(15 citation statements)

References 20 publications

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“…Oxygen therapy can cost less than 1 cent per litre (161) and when oxygen was introduced in Papua New Guinea, child mortality was reduced by 35% at a cost of US$50 per disability-adjusted life-year averted (162). In Uganda, a simple and inexpensive sepsis protocol reduced mortality by 26% (123) and emergency surgery was found to be more cost-effective than other public health interventions (80).…”

Section: Critical Care Can Be Simple and Appropriate For Low Resourcementioning

confidence: 99%

Single Deranged Physiologic Parameters Are Associated With Mortality in a Low-Income Country

Baker

Blixt

Lugazia

et al. 2015

Critical Care Medicine

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Single deranged physiologic parameters at admission are associated with mortality in a critically ill population in a low-income country. As a measure of illness severity, single deranged physiologic parameters are as useful as a compound scoring system in this setting and could be termed "danger signs." Danger signs may be suitable for the basis of routines to identify and treat critically ill patients.

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Section: Critical Care Can Be Simple and Appropriate For Low Resourcementioning

confidence: 99%

Single Deranged Physiologic Parameters Are Associated With Mortality in a Low-Income Country

Baker

Blixt

Lugazia

et al. 2015

Critical Care Medicine

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“…Finally, the potential cost saving when performing groin hernia surgery under local anaesthesia as day‐case surgery, instead of the mean length of stay of 5·5 days following groin hernia repair in the neighbouring district, was $44·9 (€42·5).…”

Section: Resultsmentioning

confidence: 99%

“…It is currently not affordable in public healthcare systems in poor settings, or to the vast majority of patients in Uganda and other low‐income countries. When surgery was performed by Ugandan surgeons, using the low‐cost mesh, operating under local anaesthesia and in ambulatory services, the total cost was lower than that for a standard non‐mesh groin hernia repair in the neighbouring district. Groin hernia repair under local anaesthesia as day‐case surgery is cost‐saving and was well tolerated by patients.…”

Section: Discussionmentioning

confidence: 99%

“…This technique is superior to previously used sutured techniques, in terms of recurrence risk. A commercial mesh normally costs US $100 (€95) or more, which would more than double the cost of the operation in countries such as Uganda. This practice is not affordable to healthcare systems and patients in many low‐ and middle‐income countries (LMICs).…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness of groin hernia repair from a randomized clinical trial comparing commercial versus low-cost mesh in a low-income country

Löfgren

Matovu

Wladis

et al. 2017

British Journal of Surgery

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“…With respect to current literature, the proportion of physicians and surgeons required to serve the needs of the population in sub-Saharan Africa is high. 5,9,10 Because it is not realistic to expect national governments to solve this structural and economic problem in the near future, development aid needs to focus on this issue. 11,12 A feasible way to improve local surgical capacity could be by promoting MSTs to deliver surgical care to the austere regions of Africa.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Mesh Repair for Inguinal Hernia During a Humanitarian Surgical Mission in Rural Nigeria

Oehme¹,

Beeres²,

Fourie³

et al. 2019

International Surgery

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Background: Humanitarian short-term surgery missions remain under debate, even though the proportion of the burden of surgical diseases around the world that could be treated based on surgery is constantly rising. The primary objective of this study was to prove the cost-effectiveness (CE) of a hernia repair–teaching mission in the rural setting of Nigeria. Methods: We present a CE analysis (CEA) of a 2-week surgery mission performing inguinal hernias with mesh repair according to the Lichtenstein maneuver. All data were collected prospectively. The contribution to the local health system was measured based on the disability-adjusted life years (DALYs). Further on, the CEA was analyzed and separated for surgeons from Nigeria and Europe, respectively. Results: During this mission a total of 107 patients with 123 hernias were treated. An average of 6,61 DALYs per patient were averted. The total costs for the mission team amounted to $8485.26, with a total of $19,210.73 from a societal perspective. Single-procedure costs amounted to $198.87 per patient, with $39.35 per procedure from a patient perspective. The CEA showed $31.04/DALY averted from a societal perspective, $13.71/DALY averted from a provider perspective, and $6.81/DALY averted from a patient perspective. This was well below the threshold of $2790 (gross domestic product per capita). Sensitivity analysis showed robust results. Conclusion: With these results we proved CE and remained about 90 times below the threshold of the gross domestic product per capita.

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Cost of surgery in a low-income setting in eastern Uganda

Cited by 20 publications

References 20 publications

Single Deranged Physiologic Parameters Are Associated With Mortality in a Low-Income Country

Single Deranged Physiologic Parameters Are Associated With Mortality in a Low-Income Country

Cost-effectiveness of groin hernia repair from a randomized clinical trial comparing commercial versus low-cost mesh in a low-income country

Cost-Effectiveness Analysis of Mesh Repair for Inguinal Hernia During a Humanitarian Surgical Mission in Rural Nigeria

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