Short-term general, gynecologic, orthopedic, and pediatric surgical mission trips in Nicaragua: A cost-effectiveness analysis
Journal – Journal of Global Health
Article type – Journal research article – Clinical research
Publication date – May – 2021
Authors – Keyanna P Taylor , Anna Ortiz , Jason Paltzer
Keywords – LMICs, non-governmental organizations, surgical missions
Open access – Yes
Speciality – General surgery, Obstetrics and Gynaecology, Paediatric surgery, Trauma and orthopaedic surgery
World region Central America
Language – English
Submitted to the One Surgery Index on June 4, 2021 at 7:15 am
Background Short-term surgical missions facilitated by non-governmental organizations (NGOs) may be a possible platform for cost-effective international global surgical efforts. The objective of this study is to determine if short-term surgical mission trips provided by the non-governmental organization (NGO) Esperança to Nicaragua from 2016 to 2020 are cost-effective.
Methods Using a provider perspective, the costs of implementing the surgical trips were collected via Esperança’s previous trip reports. The reports and patient data were analyzed to determine disability-adjusted life years averted from each surgical procedure provided in Nicaragua from 2016-2020. Average cost-effectiveness ratios for each surgical trip specialty were calculated to determine the average cost of averting one disability adjusted life year.
Results Esperança’s surgical missions’ program in Nicaragua from 2016 to 2020 was found to be cost-effective, with pediatric and gynecology surgical specialties being highly cost-effective and general and orthopedic surgical specialties being moderately cost-effective. These results were echoed in both scenarios of the sensitivity analysis, except for the orthopedic specialty which was found to not be cost-effective when testing an increased discount rate.
Conclusions The cost-effectiveness of short-term surgical missions provided by NGOs can be cost-effective, but limitations include inconsistent data from a societal perspective and lack of an appropriate counterfactual. Future studies should examine the capacity for NGOs to collect adequate data and conduct rigorous economic evaluations
OSI Number – 21116