Top

World Journal of Surgery

Published in:

01-05-2016 | Original Scientific Report

Cost Per DALY Averted in a Surgical Unit of a Private Hospital in India

Authors: Susmita Chatterjee, Ramanan Laxminarayan, Richard A. Gosselin

Published in: World Journal of Surgery | Issue 5/2016

Abstract

Backgrounds

Cost-effectiveness analysis plays an important role to guide resource allocation decisions, however, information on cost per disability-adjusted life year (DALY) averted by health facilities is not available in many developing economies, including India. We estimated cost per DALY averted for 2611 patients admitted for surgical interventions in a 106-bed private for-profit hospital in northern India.

Methods

Costs were calculated using standard costing methods for the financial year 2012–2013, and effectiveness was measured in DALYs averted using risk of death/disability, effectiveness of treatment and disability weights from 2010 global burden of disease study.

Results

During the study period, total operating cost of the hospital for treating surgical patients was USD 1,554,406 and the hospital averted 9401 DALYs resulting in a cost per DALY averted of USD 165.

Conclusions

Even though this study was based on one hospital in India, however, the hospital is a private hospital which is expected to have less surgical case load compared to government health facilities, cost per DALY averted for the surgical interventions is much lower than the cost-effectiveness threshold for India (USD 1508 in 2012). This study therefore provides evidence to re-think the common notion that surgical care is expensive and therefore of lower value than other health interventions.

Chen AT, Pedtke A, Kobs JK et al (2012) Volunteer orthopedic surgical trips in Nicaragua: a cost-effectiveness evaluation. World J Surg 36:2802–2808CrossRefPubMed

Moon W, Perry H, Baek RM (2012) Is international volunteer surgery for cleft lip and cleft palate a cost-effective and justifiable intervention? A case study from East Asia. World J Surg 36:2819–2830CrossRefPubMed

Gosselin RA, Gialamas G, Atkin DM (2011) Comparing the cost-effectiveness of short orthopedic missions in elective and relief situations in developing countries. World J Surg 35:951–955CrossRefPubMedPubMedCentral

Singh AJ, Garner P, Floyd K (2000) Cost-effectiveness of public funded options for cataract surgery in Mysore, India. Lancet 355:180–184CrossRefPubMed

McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynecol Obstet 81:83–92CrossRef

Gosselin RA, 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 RA, Heitto M (2008) Cost-effectiveness of a district trauma hospital in Battambang, Cambodia. World J Surg 32:2450–2453CrossRefPubMed

Gosselin RA, Maldonado A, Elder G (2010) Comparative cost-effectiveness analysis of two MSF surgical trauma centers. World J Surg 34:415–419CrossRefPubMedPubMedCentral

Baltussen R, Sylla M, Mariotti SP (2004) Cost-effectiveness analysis of cataract surgery: a global and regional analysis. Bull World Health Organ 82:338–345PubMedPubMedCentral

10.

Baltussen RM, Sylla M, Frick KD et al (2005) Cost-effectiveness of trachoma control in seven world regions. Ophthalmic Epidemiol 12:91–101CrossRefPubMed

11.

Corlew DS (2010) Estimation of impact of surgical disease through economic modeling of cleft lip and palate care. World J Surg 34:391–396CrossRefPubMed

12.

Alkire BC, Vincent JR, Burns CT et al (2012) Obstructed labour and caesarean delivery: the cost and benefit of surgical intervention. PLoS One 7:e34594CrossRef

13.

Drummond MF, Sculpher MJ, Torrance GW et al (2005) In: methods for the economic evaluation of health care programmes. Oxford University Press, Oxford

14.

Chatterjee S, Levin C, Laxminarayan R (2013) Unit cost of medical services at different hospitals in India. PLoS One 8:e69728CrossRefPubMedPubMedCentral

15.

Government of India (2013), Department of Revenue, Ministry of Finance, New Delhi

16.

Edejer TT-T, Baltussen R, Adam T et al (2003) In: Making choices in health: WHO guide to cost-effectiveness analysis. World Health Organization, Geneva

17.

Murray CJL, Lopez AD (eds) (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard University Press, Cambridge

18.

Salomon JA, Vos T, Hogan DR et al (2012) Common values in assessing health outcomes from disease and injury: disability weights measurement study for the global burden of disease study 2010. Lancet 380:2129–2143CrossRefPubMed

19.

Government of India, Ministry of Health and Family Welfare (2010) Annual report to the people on health

20.

Laxminarayan R, Chow J, Shahid-Salles SA (2006) Intervention cost-effectiveness: overview of main messages. In: Jamison DT, Breman JG, Measham AR et al (eds) Disease control priorities in developing countries, vol 2. Oxford University Press, Washington DC, pp 35–86

21.

Kim SY, Goldie SJ, Salomon JA (2009) Cost-effectiveness of rotavirus vaccination in Vietnam. BMC Public Health 9:29CrossRefPubMedPubMedCentral

22.

Chatterjee S, Laxminarayan R (2013) Costs of surgical procedures in Indian hospitals. BMJ Open 3:e002844CrossRefPubMedPubMedCentral

23.

World Bank website. Available http://data.worldbank.org/indicator/NY.GNP.PCAP.CD/countries. Accessed 27 July 2014

24.

Arnesen T, Nord E (1999) The value of DALY life: problems with ethics and validity of disability adjusted life years. BMJ 319:1423–1425CrossRefPubMedPubMedCentral

25.

Reidpath DD, Allotey PA, Kouame A et al (2003) Measuring health in a vacuum: examining the disability weight of the DALY. Health Policy Plan 18:351–356CrossRefPubMed

26.

Gosselin R, Ozgediz D, Poenaru D (2013) A square peg in a round hole? Challenges with DALY based “burden of disease” calculations in surgery and a call for alternative metrics. World J Surg 37:2507–2511CrossRefPubMed

27.

Minh HV, Giang KB, Huong DL et al (2010) Costing of clinical services in rural district hospitals in northern Vietnam. Int J Health Plan Manag 25:63–73

28.

Riewpaiboon A, Chatterjee S, Piyauthakit P (2011) Cost analysis for efficient management: diabetes treatment at a public district hospital in Thailand. Int J Pharm Pract 19:342–349CrossRefPubMed

Title: Cost Per DALY Averted in a Surgical Unit of a Private Hospital in India
Authors: Susmita Chatterjee
Ramanan Laxminarayan
Richard A. Gosselin
Publication date: 01-05-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 5/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3376-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Cost Per DALY Averted in a Surgical Unit of a Private Hospital in India

Abstract

Backgrounds

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Backgrounds

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2016

Efficacy and Toxicity of Hepatic Intra-Arterial Drug-Eluting (Irinotecan) Bead (DEBIRI) Therapy in Irinotecan-Refractory Unresectable Colorectal Liver Metastases

Implementation of Enhanced Recovery (ERAS) in Colorectal Surgery Has a Positive Impact on Non-ERAS Liver Surgery Patients

Significance of R1 Resection for Advanced Colorectal Liver Metastases in the Era of Modern Effective Chemotherapy

Surgical Apgar Score Predicted Postoperative Morbidity After Esophagectomy for Esophageal Cancer

First Episode of Spontaneous Pneumothorax: CT-based Scoring to Select Patients for Early Surgery

Clinicopathologic Differences in Patients with Gallbladder Cancer According to the Presence of Anomalous Biliopancreatic Junction