Jenny Löfgren1, Jude Mulowooza2, Pär Nordin3, Andreas Wladis4, Birger C Forsberg5. 1. Department of Surgery and Perioperative Sciences, Umeå University Hospital, Umeå, Sweden. Electronic address: jenny.loefgren@gmail.com. 2. Iganga General Hospital, Iganga, Uganda. 3. Department of Surgery and Perioperative Sciences, Umeå University Hospital, Umeå, Sweden. 4. Department of Clinical Science and Education (KI SÖS), Södersjukhuset, Karolinska Institute, Stockholm, Sweden. 5. Department of Public Health Sciences, Karolinska Institute, Solna, Sweden.
Abstract
BACKGROUND: Operative interventions have traditionally been seen as expensive; therefore, surgery has been given low priority in global health care planning in low-income countries. A growing body of evidence indicates that surgery can also be highly cost effective in low-income settings, but our current knowledge of the actual cost of surgery in such settings is limited. This study was carried out to obtain data on the costs of commonly performed operative procedures in a rural/semiurban setting in eastern Uganda. METHODS: A prospective, facility-based study carried out at a general district hospital (public) and a mission hospital (private, not-for-profit) in the Iganga and Mayuge districts in eastern Uganda. Items included in the cost calculations were staff time, materials and medicines, overhead costs, and capital costs. RESULTS: The cost of surgery was higher at the mission hospital, with higher expenditure and lower productivity than the public hospital. The most commonly performed major procedures were caesarean section, uterine evacuation, and herniorrhaphy for groin hernia. The costs for these interventions varied between $68.4 and $74.4, $25.0 and $32.6, and $58.6 and $66.0, respectively. The most commonly performed minor procedures were circumcision, suture of cuts and lacerations, and incision and drainage of abscess. The costs for these interventions varied between $16.2 and $24.6, $15.8 and $24.3, and $10.1 and $18.6, respectively. CONCLUSION: The cost of surgery in the study setting compares favorably with other prioritized health care interventions, such as treatment for tuberculosis, human immunodeficiency virus/AIDS, and childhood immunization. Surgery in low-income settings can be made more cost effective, leading to increased quantity and improved quality of surgical services.
BACKGROUND: Operative interventions have traditionally been seen as expensive; therefore, surgery has been given low priority in global health care planning in low-income countries. A growing body of evidence indicates that surgery can also be highly cost effective in low-income settings, but our current knowledge of the actual cost of surgery in such settings is limited. This study was carried out to obtain data on the costs of commonly performed operative procedures in a rural/semiurban setting in eastern Uganda. METHODS: A prospective, facility-based study carried out at a general district hospital (public) and a mission hospital (private, not-for-profit) in the Iganga and Mayuge districts in eastern Uganda. Items included in the cost calculations were staff time, materials and medicines, overhead costs, and capital costs. RESULTS: The cost of surgery was higher at the mission hospital, with higher expenditure and lower productivity than the public hospital. The most commonly performed major procedures were caesarean section, uterine evacuation, and herniorrhaphy for groin hernia. The costs for these interventions varied between $68.4 and $74.4, $25.0 and $32.6, and $58.6 and $66.0, respectively. The most commonly performed minor procedures were circumcision, suture of cuts and lacerations, and incision and drainage of abscess. The costs for these interventions varied between $16.2 and $24.6, $15.8 and $24.3, and $10.1 and $18.6, respectively. CONCLUSION: The cost of surgery in the study setting compares favorably with other prioritized health care interventions, such as treatment for tuberculosis, human immunodeficiency virus/AIDS, and childhood immunization. Surgery in low-income settings can be made more cost effective, leading to increased quantity and improved quality of surgical services.
Authors: Dennis Cornelissen; Gerald Mwapasa; Jakub Gajewski; Tracey McCauley; Eric Borgstein; Ruairi Brugha; Leon Bijlmakers Journal: World J Surg Date: 2018-01 Impact factor: 3.352
Authors: Geoffrey A Anderson; Lenka Ilcisin; Peter Kayima; Lenard Abesiga; Noralis Portal Benitez; Joseph Ngonzi; Mayanja Ronald; Mark G Shrime Journal: PLoS One Date: 2017-10-31 Impact factor: 3.240
Authors: Eva Glaeser; Bart Jacobs; Bernd Appelt; Elias Engelking; Ir Por; Kunthea Yem; Steffen Flessa Journal: Int J Environ Res Public Health Date: 2020-11-02 Impact factor: 3.390