Evidence map›Paper›PMID 36918844›Full record

ArticleBMC health services research2023

A cost-effectiveness analysis of surgical care delivery in Eastern Uganda-a societal perspective.

Obieze Nwanna-Nzewunwa, Esther Agwang, Melissa Carvalho, Mary-Margaret Ajiko, Rasheedat Oke, Christopher Yoon, Mohamed M Diab, Fred Kirya, Elliot Marseille, Catherine Juillard and 1 more

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Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Obieze Nwanna-NzewunwaDepartment of Surgery, Maine Medical Center, 22 Bramhall Street, Portland, ME, 04102, USA.
Esther AgwangDepartment of Surgery, Soroti Regional Referral Hospital, Soroti, Uganda.
Melissa CarvalhoProgram for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA.
Mary-Margaret AjikoDepartment of Surgery, Soroti Regional Referral Hospital, Soroti, Uganda.
Rasheedat OkeProgram for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA.
Christopher YoonDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Mohamed M DiabDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Fred KiryaDepartment of Surgery, Soroti Regional Referral Hospital, Soroti, Uganda.
Elliot MarseillePrincipal, Health Strategies International, 555 59th Street, Oakland, CA, USA.
Catherine JuillardProgram for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA.
Rochelle A DickerProgram for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA. rdicker@mednet.ucla.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe mismatch between the global burden of surgical disease and global health funding for surgical illness exacerbates disparities in surgical care access worldwide. Amidst competing priorities, governments need to rationally allocate scarce resources to address local needs. To build an investment case for surgery, economic data on surgical care delivery is needed. This study focuses on femur fractures.

methodsThis prospective cohort study at Soroti Regional Referral Hospital (SRRH), captured demographic, clinical, and cost data from all surgical inpatients and their caregivers at SRRH from February 2018 through July 2019. We performed descriptive and inferential analyses. We estimated the cost effectiveness of intramedullary nailing relative to traction for femur fractures by using primary data and making extrapolations using regional data.

resultsAmong the 546 patients, 111 (20.3%) had femur fractures and their median [IQR] length of hospitalization was 27 days [14, 36 days]. The total societal cost and Quality Adjusted Life Year (QALY) gained was USD 61,748.10 and 78.81 for femur traction and USD 23,809 and 85.47 for intramedullary nailing. Intramedullary nailing was dominant over traction of femur fractures with an Incremental Cost Effectiveness Ratio of USD 5,681.75 per QALY gained.

conclusionFemur fractures are the most prevalent and most expensive surgical condition at SRRH. Relative to intramedullary nailing, the use of femur traction at SRRH is not cost effective. There is a need to explore and adopt more cost-effective approaches like internal fixation.

Indexed as

Cost-Effectiveness AnalysisFemoral FracturesCost-Benefit AnalysisHumansProspective StudiesUgandaAfricaCost-effectivenessEpidemiologyFemur fracturesGlobal SurgeryQALYSocietal costSurgical care costUganda

Identifiers

PMID36918844
PMCPMC10015833

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