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. 2017 Mar 14:8:37.
doi: 10.4103/sni.sni_199_16. eCollection 2017.

Cost-effectiveness of short-term neurosurgical missions relative to other surgical specialties

Maria Punchak  1 , Jorge A Lazareff  1
Affiliations

Cost-effectiveness of short-term neurosurgical missions relative to other surgical specialties

Maria Punchak et al. Surg Neurol Int. .

Abstract

Background: Short-term surgical relief efforts have helped close some gaps in the provision of surgical care in remote settings. We reviewed the published literature on short-term surgical missions to compare their cost-effectiveness across subspecialties.

Methods: PubMed was searched using the algorithm ["cost-effectiveness" AND "surgery" AND ("mission" OR "volunteer")]. Articles detailing the cost-effectiveness of short-term surgical missions in low and middle-income countries (LMIC) were included. Only direct mission costs were considered, and all costs were converted into 2014 USD.

Results: Eight articles, representing 27 missions in 9 LMIC countries during 2006-2014, met our inclusion criteria. Latin America was the most frequently visited region. Per capita costs ranged from $259 for cleft lip/cleft palate (CL/CP) missions to $2900 for a neurosurgery mission. Mission effectiveness ranged from 3 disability adjusted life years (DALYs) averted per patient for orthopedic surgery missions to 8.12 DALYs averted per patient for a neurosurgery mission. CL/CP and general surgery missions were the most cost-effective, averaging $80/DALY and $87/DALY, respectively. The neurosurgical, orthopedic, and hand surgery missions averaged the highest costs/DALY averted, with the cost-effectiveness being $357/DALY, $435/DALY, and $445/DALY, respectively. All analyzed missions were very cost effective.

Conclusion: To date, this is the first study to assess the cost-effectiveness of short-term surgical missions across surgical specialties. Neurosurgical missions avert the largest number of healthy life years compared to other specialties, and thus, could yield a greater long-term benefit to resource-poor communities. We recommend that further studies be carried out to assess the impact of surgical missions in low-resource settings.

Keywords: Cost-effectiveness; global surgery; low and middle income countries; medical missions; neurosurgery.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Per capita mission effectiveness and cost-effectiveness, by surgical specialty
See this image and copyright information in PMC

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