The Clinical and Economic Impact of a Sustained Program in Global Plastic Surgery

Hughes, Christopher D.; Babigian, Alan; McCormack, Susan; Alkire, Blake C; Wong, Anselm; Pap, Stephen; Vincent, Jeffrey R.; Meara, John G.; Castiglione, Charles L.; Silverman, Richard

doi:10.1097/prs.0b013e318254b2a2

Cited by 48 publications

(45 citation statements)

References 23 publications

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“…Although the cost effectiveness of surgical treatment of cleft palate is well demonstrated by analytic models [15, 16, 82], medical missions may not optimize the return on relatively scarce financial investments in cleft care, in terms of value to individual patients and local communities. The significant financial overhead of medical missions may ultimately detract resources from the patients who need those resources the most.…”

Section: Building Capacity While Addressing Specific Needs: a Diagmentioning

confidence: 99%

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Patel

Hoyler

Maine

et al. 2012

Plastic Surgery International

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Global cleft surgery missions have provided much-needed care to millions of poor patients worldwide. Still, surgical capacity in low- and middle-income countries is generally inadequate. Through surgical missions, global cleft care has largely ascribed to a vertical model of healthcare delivery, which is disease specific, and tends to deliver services parallel to, but not necessarily within, the local healthcare system. The vertical model has been used to address infectious diseases as well as humanitarian emergencies. By contrast, a horizontal model for healthcare delivery tends to focus on long-term investments in public health infrastructure and human capital and has less often been implemented by humanitarian groups for a variety of reasons. As surgical care is an integral component of basic healthcare, the plastic surgery community must challenge itself to address the burden of specific disease entities, such as cleft lip and palate, in a way that sustainably expands and enriches global surgical care as a whole. In this paper, we describe a diagonal care delivery model, whereby cleft missions can enrich surgical capacity through integration into sustainable, local care delivery systems. Furthermore, we examine the applications of diagonal development to cleft care specifically and global surgical care more broadly.

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Section: Building Capacity While Addressing Specific Needs: a Diagmentioning

confidence: 99%

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Patel

Hoyler

Maine

et al. 2012

Plastic Surgery International

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“…[7][8][9][10][11][12] In response, many surgeons have highlighted the role that academic support could play in transforming the field of global surgery from short-term, independent mission trips to long-term, capacity-building partnerships. [13][14][15][16][17][18] These partnerships would subsequently strengthen surgical systems, reinforce evidence-based care, and provide research opportunities in both settings. 12,14,19 Sustainable collaborations with recurring, bidirectional partnering of clinical, research, and educational initiatives have been described as a means of providing human and physical resources and clinical and academic capacities.…”

Section: Introductionmentioning

confidence: 99%

Building a Global Surgery Initiative Through Evaluation, Collaboration, and Training: The Massachusetts General Hospital Experience

Chao

Riesel

Anderson

et al. 2015

Journal of Surgical Education

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“…Because of the integral nature of surgery in a health system and because surgery has been shown to be cost-effective, 8,9,11,20,21 the expansion of surgical delivery is necessary in many countries as they work to achieve universal health coverage. 6,7 How far this expansion should go is unclear: should, for example, countries aim for surgical delivery mimicking that in the greatest-producing countries of the United States and Norway?…”

Section: Discussionmentioning

confidence: 99%

Half a billion surgical cases: Aligning surgical delivery with best-performing health systems

Shrime

Daniels

Meara

2015

Surgery

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Background Surgical delivery varies 200-fold across countries. No direct correlation exists, however, between surgical delivery and health outcomes, making it difficult to pinpoint a goal for surgical scale-up. This report determines the amount of surgery that would be delivered worldwide if the world aligned itself with countries providing the best health outcomes. Methods Annual rates of surgical delivery have been published previously for 129 countries. Five health outcomes were plotted against reported surgical delivery. Univariate and multivariate polynomial regression curves were fit, and the optimal point on each regression curve was determined by solving for first-order conditions. The country closest to the optimum for each health outcome was taken as representative of the best-performing health system. Monetary inputs to and surgical procedures provided by these systems were scaled to the global population. Results For 3 of the 5 health outcomes, optima could be found. Globally, 315 million procedures currently are provided annually. If global delivery mirrored the 3 best-performing countries, between 360 million and 460 million cases would be provided annually. With population growth, this will increase to approximately half a billion cases by 2030. Health systems delivering these outcomes spend approximately 10% of their GDP on health. Conclusion This is the first study to provide empirical evidence for the surgical output that an ideal health system would provide. Our results project ideal delivery worldwide of approximately 550 million annual surgical cases by 2030.

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The Clinical and Economic Impact of a Sustained Program in Global Plastic Surgery

Abstract: Plastic surgical disease is a significant source of morbidity for patients in resource-limited regions. Dedicated programs that provide essential reconstructive surgery can produce substantial clinical and economic benefits to host countries.

Cited by 48 publications

References 23 publications

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Building a Global Surgery Initiative Through Evaluation, Collaboration, and Training: The Massachusetts General Hospital Experience

Half a billion surgical cases: Aligning surgical delivery with best-performing health systems

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