Cost-Effectiveness Analysis of Total Hip Arthroplasty Performed by a Canadian Short-Stay Surgical Team in Ecuador. (18th December 2017)

• Record Type: Journal Article
• Authors: Schlegelmilch, Michael; Rashiq, Saifee; Moreau, Barbara; Jarrín, Patricia; Tran, Bach; Chuck, Anderson
• Other Names: Carl Allen L. Academic Editor.
• Is Part Of: Advances in orthopedics. Volume 2017(2017)
• Publication Date: 2017-12-18
• Subjects: Orthopedics -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedics; Electronic journals; Periodicals; Periodicals; 616.7
• DOI: 10.1155/2017/5109895
• Languages: English
• ISSNs: 2090-3464

Abstract

Abstract : Background . Few charitable overseas surgical missions produce cost-effectiveness analyses of their work. Methods . We compared the pre- and postoperative health status for 157 total hip arthroplasty (THA) patients operated on from 2007 to 2011 attended by an annual Canadian orthopedic mission to Ecuador to determine the quality-adjusted life years (QALYs) gained. The costs of each mission are known. The cost per surgery was divided by the average lifetime QALYs gained to estimate an incremental cost-effectiveness ratio (ICER) in Canadian dollars per QALY. Results . The average lifetime QALYs (95% CI) gained were 1.46 (1.4–1.5), 2.5 (2.4–2.6), and 2.9 (2.7–3.1) for unilateral, bilateral, and staged (two THAs in different years) operations, respectively. The ICERs were $4, 442 for unilateral, $2, 939 for bilateral, and $4392 for staged procedures. Seventy percent of the mission budget was spent on the transport and accommodation of volunteers. Conclusion . THA by a Canadian short-stay surgical team was highly cost-effective, according to criteria from the National Institute for Health and Care Excellence and the World Health Organization. We encourage other international missions to provide similar cost-effectiveness data to enable better comparison between mission types and between mission and nonmission care.