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Cost-Effectiveness of a Pediatric Operating Room Installation in Sub-Saharan Africa
15 Pages Posted: 12 Jan 2023
More...Abstract
OBJECTIVE: To assess the cost-effectiveness of installing and maintaining a pediatric operating room in a hospital in Sub-Saharan Africa (SSA) with a pre-existing pediatric surgical service.
METHODS: We constructed a decision tree to model pediatric surgical delivery at a regional hospital in Nigeria over a year, comparing scenarios before and after the installation of two dedicated pediatric operating rooms (ORs), which were funded philanthropically. Health outcomes measured in disability-adjusted life years (DALYs) averted were informed by the hospital’s operative registry and prior literature. A societal perspective included costs incurred by the hospital system, charity, and patients’ families. Costs were annualized and reported in 2021 United States dollars ($). We presented the incremental cost-effectiveness ratios (ICER) of the annualized OR installation from the charity and societal perspective. One-way and probabilistic sensitivity analyses were performed.
RESULTS: Installation and maintenance of two pediatric operating rooms averted 1145 DALYs and cost $155,509 annually. Annualized OR installation cost was $87,728 (56% of the overall cost). The ICER of the OR installation was $152 per DALY averted (95% uncertainty interval [UI] 147-156) from the societal perspective, and $77 per DALY averted (95% UI 75-81) from the charity perspective. These ICERs were well under the cost-effectiveness threshold of the country’s half-GDP per capita in 2020 ($1043) and remained cost-effective in one-way and probabilistic sensitivity analyses.
CONCLUSION: Installation of additional pediatric operating rooms in SSA with pre-existing pediatric surgical capacity is cost-effective, supporting investment in children’s global surgical infrastructure as an economically sound intervention.
FUNDING: This study did not have any sponsoring party or funding sources.
DECLARATION OF INTEREST: The authors have no conflict of interest or competing interests
to declare.
ETHICS APPROVAL: Abuja National Hospital and University of California San Francisco Institutional Review Board approvals were obtained for the purposes of this study.
Keywords: cost-effectiveness, economic, pediatric surgery, operating room, capacity building, global surgery, public health, infrastructure, equipment
Suggested Citation: Suggested Citation