Tadisina Kashyap K, Chopra Karan, Tangredi John, Thomson J Grant, Singh Devinder P
College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD 21287, USA.
Plast Surg Int. 2014;2014:921625. doi: 10.1155/2014/921625. Epub 2014 Aug 20.
Purpose. Congenital anomalies and injuries of the hand are often undertreated in low-middle income countries (LMICs). Humanitarian missions to LMICs are commonplace, but few exclusively hand surgery missions have been reported and none have attempted to demonstrate their cost-effectiveness. We present the first study evaluating the cost-effectiveness of a humanitarian hand surgery mission to Honduras as a method of reducing the global burden of surgically treatable disease. Methods. Data were collected from a hand surgery mission to San Pedro Sula, Honduras. Costs were estimated for local and volunteer services. The total burden of disease averted from patients receiving surgical reconstruction was derived using the previously described disability-adjusted life years (DALYs) system. Results. After adjusting for likelihood of disability associated with the diagnosis and likelihood of the surgery's success, DALYs averted totaled 104.6. The total cost for the mission was $45,779 (USD). The cost per DALY averted was calculated to be $437.80 (USD), which is significantly below the accepted threshold of two times the per capita gross national income of Honduras. Conclusions. This hand surgery humanitarian mission trip to Honduras was found to be cost-effective. This model and analysis should help in guiding healthcare professionals to organize future plastic surgery humanitarian missions.
目的。在低收入和中等收入国家（LMICs），手部先天性异常和损伤往往未得到充分治疗。前往LMICs的人道主义任务很常见，但专门的手部手术任务报道较少，且尚无研究试图证明其成本效益。我们开展了第一项研究，评估前往洪都拉斯的人道主义手部手术任务的成本效益，作为减轻可手术治疗疾病全球负担的一种方法。方法。收集了一次前往洪都拉斯圣佩德罗苏拉的手部手术任务的数据。估算了当地和志愿者服务的成本。使用先前描述的残疾调整生命年（DALYs）系统，得出接受手术重建患者避免的疾病总负担。结果。在调整与诊断相关的残疾可能性和手术成功可能性后，避免的DALYs总数为104.6。该任务的总成本为45,779美元（美元）。计算得出避免每个DALY的成本为437.80美元（美元），显著低于洪都拉斯人均国民总收入两倍的公认阈值。结论。发现这次前往洪都拉斯的手部手术人道主义任务具有成本效益。该模型和分析应有助于指导医疗保健专业人员组织未来的整形手术人道主义任务。
