ArticleWorld journal of surgery2013
Cost-effectiveness of inguinal hernia surgery in northwestern Ecuador.
Article in World journal of surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01872364 (A Material Cost-Minimization Analysis for Hernia Repairs and Minor Procedures During a Surgical Mission in the Dominican Republic), which is not on this map. Cited by 17 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Material Cost-Minimization Analysis for Hernia Repairs and Minor Procedures During a Surgical Mission in the Dominican Republic
Who cites it
17 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Economic value of international missions and domestic initiatives to strengthen surgical care in low- and middle-income countries: systematic review.The British journal of surgery · 2025Pooled it
- A Systematic Review of Orthopedic Global Outreach Efforts Based on WHO-CHOICE Thresholds.Hand clinics · 2019Pooled it
- Disability Weights for Pediatric Surgical Procedures: A Systematic Review and Analysis.World journal of surgery · 2018Pooled it
- International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018Guideline
- Economic Analysis of Children's Surgical Care in Low- and Middle-Income Countries: A Systematic Review and Analysis.PloS one · 2016Pooled it
- Cost-effectiveness of surgery in low- and middle-income countries: a systematic review.World journal of surgery · 2014Pooled it
- Minimally invasive inguinal hernia repair is superior to open: a national database review.Hernia : the journal of hernias and abdominal wall surgery · 2019Article
- Sustainability in humanitarian surgery during medical short-term trips (MSTs): feasibility of inguinal hernia repair in rural Nigeria over 6 years and 13 missions.Hernia : the journal of hernias and abdominal wall surgery · 2018Article
- Measuring the Burden of Surgical Disease Averted by Emergency and Essential Surgical Care in a District Hospital in Papua New Guinea.World journal of surgery · 2017Article
- Cost-effectiveness of short-term neurosurgical missions relative to other surgical specialties.Surgical neurology international · 2017Article
- Economic Valuation of the Global Burden of Cleft Disease Averted by a Large Cleft Charity.World journal of surgery · 2016Article
- The How Project: understanding contextual challenges to global surgical care provision in low-resource settings.BMJ global health · 2016Article
- The Usefulness of International Cooperation in the Repair of Inguinal Hernias in Sub-Saharan Africa.World journal of surgery · 2015Article
- An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania.Hernia : the journal of hernias and abdominal wall surgery · 2014Article
- Characterizing the global burden of surgical disease: a method to estimate inguinal hernia epidemiology in Ghana: reply.World journal of surgery · 2014Article
- A material cost-minimization analysis for hernia repairs and minor procedures during a surgical mission in the Dominican Republic.Surgical endoscopy · 2014Article
- Surgery and the global health agenda.Journal of the Royal Society of Medicine · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCost-effectiveness of tension-free inguinal hernia repair at a private 20-bed rural hospital in Esmeraldas Province, Ecuador, was calculated relative to no treatment.
methodsLichtenstein repair using mosquito net or polypropylene commercial mesh was provided to patients with inguinal hernia by surgeons from Europe and North America. Prospective data were collected from provider, patient, and societal perspectives, with component costs collected on site and from local supply companies or published literature. Patient outcomes were forecasted using disability adjusted life years (DALYs) averted. Uncertainty in patient-level data was evaluated with Monte-Carlo simulation.
resultsSurgery was provided to 102 patients with inguinal hernias of various sizes. Local anesthesia was used for 80 % of operations during the first mission, and spinal anesthesia was used for 89 % in the second mission. Few complications were observed. An average 6.39 DALYs (3,0) were averted per patient (95 % confidence interval: 6.22-6.84). The average cost per patient was US$499.33 (95 % CI: US$490.19-$526.03) from a provider perspective, US$118.79 (95 % CI: US$110.28-$143.72) from a patient perspective, and US$615.46 (95 % CI: US$603.39-$650.40) from a societal perspective. Mean cost-effectiveness from a provider perspective was US$78.18/DALY averted (95 % CI: US$75.86-$85.78) according to DALYs (3,0) averted using the West Life Table level 26, well below the Ecuadorian per-capita Gross National Income (US$3,850). Results were robust to all sensitivity analyses.
conclusionsInguinal hernia repair was cost-effective in western Ecuador through international collaboration.
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