Department of Plastic and Oral Surgery, Children's Hospital Boston, and Department of Global Health and Social Medicine, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
World J Surg. 2011 Jun;35(6):1194-201. doi: 10.1007/s00268-011-1055-1.
Acceptance of basic surgical care as an essential element of any properly functioning health system is growing. To justify investment in surgical interventions, donors require estimates of the economic benefit of treating surgical disease. The present study aimed to establish a methodology for valuing the potential economic benefit of surgical intervention using cleft lip and palate (CLP) in sub-Saharan Africa (SSA) as a model.
Economic modeling of cleft lip and cleft palate (CLP) in SSA was performed with retrospective demographic and economic data from 2008. The total number of Disability-Adjusted Life-Years (DALYs) secondary to CLP in 2008 was calculated from accepted clefting incidence rates and disability weights taken from the Global Burden of Disease Project. DALYs were then converted to monetary terms ($US), using both a human capital approach and Value of a Statistical Life (VSL) approach.
With the human capital approach, the potential economic benefit if all incident cases of CLP in SSA in 2008 were repaired at birth ranged from $252 million to $441 million. With VSL, the potential economic benefit of the same CLP repair would range from $5.4 billion to $9.7 billion.
Cleft lip and cleft palate can have a substantial impact on the economic health of countries in the developing world. Further studies should be directed at quantifying the economic benefit of surgical interventions and quantifying their costs with an economically sound approach.
接受基本的外科护理作为任何运作良好的卫生系统的基本要素的观念正在不断增强。为了证明对外科干预措施进行投资的合理性,捐赠者需要对治疗外科疾病的经济效益进行评估。本研究旨在建立一种使用裂唇裂腭(CLP)作为模型来评估外科干预潜在经济效益的方法。
使用 2008 年的回顾性人口统计学和经济学数据,对撒哈拉以南非洲(SSA)的 CLP 进行经济建模。根据公认的裂唇腭裂发病率和全球疾病负担项目中的残疾权重,计算出 2008 年由 CLP 导致的伤残调整生命年(DALY)总数。然后使用人力资本法和生命统计学价值(VSL)法将 DALY 转换为货币价值(美元)。
根据人力资本法,如果修复所有 2008 年 SSA 中发生的 CLP 病例,其潜在经济效益在 2520 万至 4410 万美元之间。采用 VSL,同样的 CLP 修复的潜在经济效益将在 54 亿至 97 亿美元之间。
裂唇裂腭会对发展中国家的经济健康产生重大影响。进一步的研究应集中于量化外科干预措施的经济效益,并采用经济合理的方法量化其成本。