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Published in: World Journal of Surgery 3/2010

01-03-2010

Cleft Lip and Palate as a Cost-effective Health Care Treatment in the Developing World

Authors: William P. Magee Jr., Richard Vander Burg, Kristin Ward Hatcher

Published in: World Journal of Surgery | Issue 3/2010

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Abstract

Background

The considerable number of surgical procedures performed each year, as well as the significant burden of surgical disease globally, have brought surgery into the arena of public health concerns. Several articles have shown the cost-effectiveness of surgical interventions in the developing world. The authors suggest that surgery has an important role in global public health, specifically through international volunteer surgical missions as a vehicle for delivery.

Methods

Eight Operation Smile medical missions from 2008 are analyzed using the disability-adjusted life year (DALY) framework and disability weights from the life tables of the first Disease Control Priorities Project (DCP1). The DCP1 life tables suggest that the entire burden of disease from a cleft lip and palate is incurred within the first 4 years of life. The same group of missions is analyzed using life tables modified by the authors to reflect the disability associated with cleft lip and palate that goes beyond the first 5 years of life.

Results

Using the DCP1 life tables, the cost per patient during the eight Operation Smile missions analyzed was $278 and $1827 with an average of $796. Using the life tables modified by the authors, the cost per patient was between $7.36 and $96.04 (average $33.94).

Conclusions

The absence of disability weights for untreated cleft lip and palate after the fifth year of life does not fit with the reality of living with an unrepaired cleft lip or palate. The authors conclude that secondary interventions alleviate disability and should enable an individual to approach a zero residual disability weight.
Literature
1.
go back to reference World Health Organization (2006) Addressing the global challenges of craniofacial anomalies. Report of a WHO meeting on International Collaborative Research on Craniofacial Anomalies. Human Genetics Project. WHO, Geneva World Health Organization (2006) Addressing the global challenges of craniofacial anomalies. Report of a WHO meeting on International Collaborative Research on Craniofacial Anomalies. Human Genetics Project. WHO, Geneva
3.
go back to reference Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison D, Brenan J, Measham A et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York, pp 1245–1260 Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison D, Brenan J, Measham A et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York, pp 1245–1260
5.
go back to reference Ozgediz D, Jamison D, Cherian M et al (2008) The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 86:646–647CrossRefPubMed Ozgediz D, Jamison D, Cherian M et al (2008) The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 86:646–647CrossRefPubMed
6.
go back to reference Ozgediz D, Riviello R (2008) The “other” neglected diseases in global public health: surgical conditions in Sub-Saharan Africa. PLoS Med 5(6):e121CrossRefPubMed Ozgediz D, Riviello R (2008) The “other” neglected diseases in global public health: surgical conditions in Sub-Saharan Africa. PLoS Med 5(6):e121CrossRefPubMed
7.
go back to reference Farmer PE, Kim JY (2008) Surgery and global health: A view from beyond the OR. World J Surg 32:533–536CrossRefPubMed Farmer PE, Kim JY (2008) Surgery and global health: A view from beyond the OR. World J Surg 32:533–536CrossRefPubMed
8.
go back to reference Murray CJ (1994) Quantifying the burden of disease: the technical basis for disability adjusted life years. Bull World Health Organ 72:429–445PubMed Murray CJ (1994) Quantifying the burden of disease: the technical basis for disability adjusted life years. Bull World Health Organ 72:429–445PubMed
11.
go back to reference McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynaecol Obstet 81:83–92CrossRefPubMed McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynaecol Obstet 81:83–92CrossRefPubMed
12.
go back to reference Gosselin TA, Thind A, Bellardinelli A (2006) Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services? World J Surg 30:505–511CrossRefPubMed Gosselin TA, Thind A, Bellardinelli A (2006) Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services? World J Surg 30:505–511CrossRefPubMed
13.
go back to reference Sherman R, Magee B (2009) International missions—cleft care. In: Losee J, Kischner R (eds) Comprehensive cleft care. McGraw-Hill, New York, pp 1029–1038 Sherman R, Magee B (2009) International missions—cleft care. In: Losee J, Kischner R (eds) Comprehensive cleft care. McGraw-Hill, New York, pp 1029–1038
14.
go back to reference Jamison DT et al (eds) (1993) Disease control priorities in developing countries. Oxford University Press, New York Jamison DT et al (eds) (1993) Disease control priorities in developing countries. Oxford University Press, New York
15.
go back to reference Harper DC, Peterson DB (2001) Children of the Philippines: attitudes toward visible physical impairment. Cleft Palate Craniofac J 38:566–576CrossRefPubMed Harper DC, Peterson DB (2001) Children of the Philippines: attitudes toward visible physical impairment. Cleft Palate Craniofac J 38:566–576CrossRefPubMed
16.
go back to reference Sell D (2008) Speech in the unoperated or late operated cleft lip and palate patient. In: Mars M, Sell D, Habel A (eds) Management of cleft lip and palate in the developing world. Wiley, Chichester, pp 179–192 Sell D (2008) Speech in the unoperated or late operated cleft lip and palate patient. In: Mars M, Sell D, Habel A (eds) Management of cleft lip and palate in the developing world. Wiley, Chichester, pp 179–192
Metadata
Title
Cleft Lip and Palate as a Cost-effective Health Care Treatment in the Developing World
Authors
William P. Magee Jr.
Richard Vander Burg
Kristin Ward Hatcher
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 3/2010
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-009-0333-7

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