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Selected Surgical Interventions in Low- and Middle-Income Countries: A Benefit-Cost Analysis

Abstract

John Meara

Objectives: In low- and middle-income countries (LMICs), studies show that many types of surgical care are more cost-effective than other health interventions. Global health funding for these interventions, on the other hand, is still sparse. To find out how economic benefits are measured, this study conducts a scoping review of previous research on the economic impact of surgical interventions in LMICs.

Design: The data were systematically reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist and the Arksey and O'Malley methodological framework for scoping reviews. We selected 19 papers that quantitatively examined the economic benefits of surgical interventions in LMICs from papers published between 2005 and 2020 using online databases.

Results: The use of disability-adjusted life years (DALYs) to measure economic impact was reported in the majority of publications (79%). In contrast, 21 percent either utilized no measure at all or alternative measures like cost-effectiveness ratios or the value of statistical life. 69% either directly assessed the economic impact in a specific area or evaluated the need for surgical procedures in LMICs, while 31% were systematic or retrospective reviews of the literature on surgical procedures in LMICs. The majority of the reviewed studies dealt with pediatric surgical procedures or a specific surgical specialty and addressed the economic impact of surgical procedures in LMICs.

Conclusion: It is necessary to accurately measure the economic impact in order to make informed policy decisions regarding investments in global health. Understanding of the overall economic value is hindered by the fact that researchers use a variety of methods to quantify the financial benefit of surgeries in LMICs. We conclude that careful selection of methods, including age and disability weights derived from the Global Burden of Disease and reporting both estimates and converting DALYs to dollars using the value of statistical life approach and the human capital approach, would benefit the literature.

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