Evidence map›Paper›PMID 42067206›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Improving access to surgical care for Inuit communities in Nunavik: a cost-savings analysis of a surgeon outreach program.

Sarah Mashal, Natasha G Caminsky, Jonathon R Campbell, Natalie Boulanger, Larry Watt, Jeremy R Grushka, Paola Fata, Dan L Deckelbaum, Kosar Khwaja, Katherine McKendy and 2 more

Abstract read
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In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Sarah MashalFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Natasha G CaminskyFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Jonathon R CampbellFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Natalie BoulangerFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Larry WattFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Jeremy R GrushkaFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Paola FataFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Dan L DeckelbaumFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Kosar KhwajaFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Katherine McKendyFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Atif JastaniahFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt).
Evan WongFrom the McGill Faculty of Medicine, Montréal, Que. (Mashal); the Division of Trauma and General Surgery, McGill University Health Centre, Montréal General Hospital Site, Montréal, Que. (Caminsky, Grushka, Fata, Deckelbaum, Khwaja, McKendy, Jastaniah, Wong); the Department of Global and Public Health, McGill University Health Centre, Montréal, Que. (Campbell); the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Boulanger, Watt). evan.wong@mcgill.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccess to timely surgical care in remote regions remains a substantial challenge. We sought to evaluate the societal costs of 2 models for delivering general surgery consultations to Nunavimmiut patients, namely an outreach model involving specialist travel to the Inuulitsivik Health Centre in Puvirnituq, and the traditional model requiring patient transfer to urban tertiary care in Montréal.

methodsWe conducted a cost analysis for all general surgery consultations from May 30, 2022, to May 24, 2024, corresponding to the first 2 years of the specialist travel program. We estimated costs across 4 representative 1-week travel periods. Direct costs included surgeon remuneration, travel, and local service expenses. Indirect costs accounted for lost wages based on the median Nunavik income. Assumptions on travel duration, accommodations, and interpreter services were based on provincial data and Ullivik historical records.

resultsThe specialist travel model was consistently less costly across all periods analyzed. Patients seen in Puvirnituq incurred lower direct and indirect costs than those transferred to Montréal. The annual cost for urban-based care was $1.86 million compared with $163 000, leading to potential cost savings of $1.7 million annually or $12 000 per consultation. Sensitivity analyses confirmed cost advantages under a broad range of assumptions.

conclusionDeploying specialists to Puvirnituq for surgical consultations is a cost-effective alternative to patient displacement. This model holds promise for improving equitable access to care in remote communities while reducing the financial burden on health care systems.

Indexed as

Cost SavingsHealth Services AccessibilityInuitHumansQuebecTravel

Identifiers

PMID42067206
PMCPMC13155878

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