Cost effectiveness of a short-term pediatric neurosurgical brigade to guatemala

Matthew C. Davis, Khoi Than, Hugh J. Garton

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective With subspecialty surgical care often unavailable to poor patients in developing countries, short-term brigades have filled a portion of the gap. We prospectively assessed the cost effectiveness of a pediatric neurosurgical brigade to Guatemala City, Guatemala.

Methods Data were collected on a weeklong annual pediatric neurosurgical brigade to Guatemala. Disability adjusted life-years (DALYs) averted were the metric of surgical effectiveness. Cost data included brigade expenses, as well as all costs incurred by the local health care system and patient families.

Results During the mission, 17 pediatric neurosurgical interventions were performed. Conditions these patients suffered would result in 382 total DALYs. Using conservative values of surgical effectiveness, procedures performed averted 138.1 DALYs. Although all operative and postoperative costs were covered by the visiting surgical team, patients spent an average of $226 in U.S. dollars for preoperative workup, travel, food/lodging, and lost wages (range, $36-$538). The local health care system absorbed a total cost of $12,910. Complete mission costs were $53,152, for a cost effectiveness of $385 per DALY averted.

Conclusions To our knowledge, this is the first study evaluating cost effectiveness of a short-term neurosurgical brigade. Although surgical intervention is acknowledged as playing a crucial role in global health, subspecialty surgical care is still broadly perceived as a luxury. Although providing care through local surgeons is undeniably more efficient than bringing in foreign medical teams, such care is not universally available. This study argues that volunteer neurosurgical teams can provide high complexity care with a competitive cost-effective profile.

Original languageEnglish (US)
Pages (from-to)974-979
Number of pages6
JournalWorld Neurosurgery
Volume82
Issue number6
DOIs
StatePublished - Dec 1 2014
Externally publishedYes

Fingerprint

Guatemala
Cost-Benefit Analysis
Quality-Adjusted Life Years
Pediatrics
Costs and Cost Analysis
Delivery of Health Care
Patient Care Team
Salaries and Fringe Benefits
Developing Countries
Volunteers
Food

Keywords

  • Cost effectiveness
  • Medical missions
  • Neurosurgery
  • Pediatrics

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

Cost effectiveness of a short-term pediatric neurosurgical brigade to guatemala. / Davis, Matthew C.; Than, Khoi; Garton, Hugh J.

In: World Neurosurgery, Vol. 82, No. 6, 01.12.2014, p. 974-979.

Research output: Contribution to journalArticle

Davis, Matthew C. ; Than, Khoi ; Garton, Hugh J. / Cost effectiveness of a short-term pediatric neurosurgical brigade to guatemala. In: World Neurosurgery. 2014 ; Vol. 82, No. 6. pp. 974-979.
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