Evidence map›Paper›PMID 38536860›Full record

ArticlePLOS global public health2024

Cost-effectiveness of a pediatric operating room installation in Sub-Saharan Africa.

Ava Yap, Salamatu I Halid, Nancy Ukwu, Ruth Laverde, Paul Park, Greg Klazura, Emma Bryce, Maija Cheung, Elliot Marseille, Doruk Ozgediz and 1 more

Abstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

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.

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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

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.

Ava YapDepartment of Surgery, University of California San Francisco, San Francisco, California, United States of America.ORCID https://orcid.org/0000-0002-4650-2845
Salamatu I HalidDivision of Paediatric Surgery, National Hospital, Abuja, Federal Capital Territory, Nigeria.
Nancy UkwuDivision of Paediatric Surgery, National Hospital, Abuja, Federal Capital Territory, Nigeria.
Ruth LaverdeDepartment of Surgery, University of California San Francisco, San Francisco, California, United States of America.
Paul ParkCenter for Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, California, United States of America.
Greg KlazuraCenter for Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, California, United States of America.ORCID https://orcid.org/0000-0003-4755-0176
Emma BryceKids Operating Room, Edinburgh, United Kingdom.ORCID https://orcid.org/0000-0002-2823-9940
Maija CheungKids Operating Room, Edinburgh, United Kingdom.ORCID https://orcid.org/0000-0002-9777-2378
Elliot MarseilleCenter of Global Health Delivery, Diplomacy, and Economics, University of California San Francisco, San Francisco, California, United States of America.
Doruk OzgedizDepartment of Surgery, University of California San Francisco, San Francisco, California, United States of America.
Emmanuel A AmehDivision of Paediatric Surgery, National Hospital, Abuja, Federal Capital Territory, Nigeria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The unmet need for pediatric surgery imposes enormous health and economic consequences globally, predominantly shouldered by Sub-Saharan Africa (SSA) where children comprise almost half of the population. Lack of knowledge about the economic impact of improving pediatric surgical infrastructure in SSA inhibits the informed allocation of limited resources towards the most cost-effective interventions to bolster global surgery for children. We assessed the cost-effectiveness of installing and running two dedicated pediatric operating rooms (ORs) in a hospital in Nigeria with a pre-existing pediatric surgical service by constructing a decision tree model of pediatric surgical delivery at this facility over a year, comparing scenarios before and after the installation of the ORs, which were funded philanthropically. Health outcomes measured in disability-adjusted life years (DALYs) averted were informed by the hospital's operative registry and prior literature. We adopted an all healthcare payor's perspective including costs incurred by the local healthcare system, the installation (funded by the charity), and patients' families. Costs were annualized and reported in 2021 United States dollars ($). The incremental cost-effectiveness ratios (ICERs) of the annualized OR installation and operation were presented. One-way and probabilistic sensitivity analyses were performed. We found that installing and operating two dedicated pediatric ORs averted 538 DALYs and cost $177,527 annually. The ICER of the ORs' installation and operation was $330 per DALY averted (95% uncertainty interval [UI] 315-336) from the all healthcare payor's perspective. This ICER was well under the cost-effectiveness threshold of the country's half-GDP per capita in 2020 ($1043) and remained cost-effective in one-way and probabilistic sensitivity analyses. Installation of additional dedicated pediatric operating rooms in Nigeria with pre-existing pediatric surgical capacity is therefore very cost-effective, supporting investment in children's global surgical infrastructure as an economically sound intervention.

Identifiers

PMID38536860
PMCPMC10971580

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.