Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services?

World Journal of Surgery
Richard A GosselinAndrea Bellardinelli

Abstract

A cost-effective analysis (CEA) can be a useful tool to guide resource allocation decisions. However, there is a dearth of evidence on the cost/disability-adjusted life year (DALY) averted by health facilities in the developing world. We conducted a study to calculate the costs and the DALYs averted by an entire hospital in Sierra Leone, using the method suggested by McCord and Chowdhury (Int J Gynaecol Obstet 2003;81:83-92). For the 3-month study period, total costs were calculated to be dollar 369,774. Using the approach of McCord and Chowdhury, we calculated that 11,282 DALYs were averted during the study period, resulting in a cost/DALY averted of dollar 32.78. This figure compares favorably to other non-surgical health interventions in developing countries. We found that while surgery accounts for 63% of total caseload, it contributes to 38% of the total DALYs averted. Surgical treatment of some common pathologies in developing countries may be more cost-effective than previously thought, and our results provide evidence for the inclusion of surgery as part of the basic public health armamentarium in developing countries. However, these results are highly context-specific, and more research is needed from developing countr...Continue Reading

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Citations

Sep 23, 2009·World Journal of Surgery·Richard A GosselinGreg Elder
Aug 24, 2010·World Journal of Surgery·Sam LubogaSudha Jayaraman
Nov 26, 2010·World Journal of Surgery·Richard A GosselinSandro Contini
Oct 8, 2009·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S D Shillcutt
Nov 10, 2012·Journal of Community Health·Mellissa WithersTara Aghaloo
Jun 28, 2008·Lancet·Stephen W Bickler, David A Spiegel
Feb 19, 2013·Journal of Tropical Pediatrics·Victor K WuMarten J Poley
Nov 3, 2011·Journal of Neurosurgery. Pediatrics·Benjamin C WarfJohn G Meara
Mar 14, 2014·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Håkon A BolkanLars Hagander
Feb 8, 2014·International Journal of Surgery·Dan PoenaruRichard A Gosselin
Jan 12, 2010·World Journal of Surgery·William P MageeKristin Ward Hatcher
Feb 11, 2015·Global Heart·Vanessa B Kerry, Jagat Narula
Feb 11, 2015·Global Heart·Vanessa B Kerry, Sadath Sayeed
Jun 16, 2011·Bulletin of the World Health Organization·Jin Yung BaeAdam L Kushner
Jan 16, 2007·World Journal of Surgery·Sandro Contini, Richard A Gosselin
Feb 27, 2008·World Journal of Surgery·Doruk OzgedizSamuel Luboga
Aug 22, 2008·World Journal of Surgery·Richard A Gosselin, Merja Heitto
Mar 26, 2009·World Journal of Surgery·Andrew N KingsnorthSamuel D Shillcutt
Aug 18, 2009·World Journal of Surgery·K A Kelly McQueenKathleen M Casey
Dec 15, 2010·World Journal of Surgery·Chris LavyEldryd Parry
Dec 17, 2010·World Journal of Surgery·David A SpiegelSalik Govind
Dec 31, 2010·World Journal of Surgery·Jonathan D PollockCarl Haisch
Apr 14, 2011·World Journal of Surgery·Michael M HaglundMichael Merson
Oct 4, 2011·World Journal of Surgery·Syed Nabeel Zafar, K A Kelly McQueen
Nov 8, 2011·World Journal of Surgery·Caris E GrimesChristopher B D Lavy
Dec 17, 2011·World Journal of Surgery·Steve KwonAdam Kushner
Aug 2, 2012·World Journal of Surgery·Syed Nabeel ZafarAdil H Haider
Oct 18, 2012·World Journal of Surgery·Samuel D ShillcuttAndrew N Kingsnorth
Oct 9, 2013·World Journal of Surgery·Caris E GrimesMichael Cotton
Dec 12, 2012·Journal of Pediatric Surgery·Doruk Ozgediz, Dan Poenaru
Nov 19, 2013·International Journal of Surgery·Sayinthen VivekananthamJoseph Shalhoub

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