From the Section of Plastic Surgery, Department of Surgery, Michigan Medicine; the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School; the Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University; and ReSurge International.
Plast Reconstr Surg. 2020 Feb;145(2):471-481. doi: 10.1097/PRS.0000000000006470.
Hand surgeons can alleviate the burden associated with various congenital anomalies, burn sequelae, and trauma that debilitate individuals in low- and middle-income countries. Because few surgeons in these areas have the necessary resources to perform complex hand surgery, surgical trips provide essential surgical care. The authors aimed to determine the economic benefit of hand surgical trips to low- and middle-income countries to comprehensively determine the economic implications of hand surgery trips in low-resource settings.
The authors collected data from two major global hand surgery organizations to analyze the economic benefit of hand surgery trips in low- and middle-income countries. The authors used both the human capital approach and the value of a statistical life-year approach to conduct this cost-benefit analysis. To demonstrate the economic gain, the authors subtracted the budgeted cost of each trip from the economic benefit.
The authors analyzed a total of 15 trips to low- and middle-income countries. The costs of the trips ranged from $3453 to $87,434 (average, $24,869). The total cost for all the surgical trips was $373,040. The authors calculated a net economic benefit of $3,576,845 using the human capital approach and $8,650,745 using the value of a statistical life-year approach.
The authors found a substantial return on investment using both the human capital approach and the value of a statistical life-year approach. In addition, the authors found that trips emphasizing education had a net economic benefit. Cost-benefit analyses have substantial financial implications and will aid policy makers in developing cost-reduction strategies to promote surgery in low- and middle-income countries.
手外科医生可以减轻与各种先天畸形、烧伤后遗症和创伤相关的负担，这些负担使中低收入国家的人丧失能力。由于这些地区很少有外科医生拥有进行复杂手部手术的必要资源，因此手术旅行提供了必要的手术护理。作者旨在确定手外科手术旅行对中低收入国家的经济效益，以全面确定在资源匮乏环境中进行手部手术旅行的经济影响。
作者从两个主要的全球手外科组织收集数据，以分析手外科手术旅行对中低收入国家的经济效益。作者使用人力资本方法和生命统计年价值方法进行这项成本效益分析。为了展示经济效益，作者从每次旅行的预算成本中减去经济收益。
作者分析了总共 15 次前往中低收入国家的旅行。旅行费用从 3453 美元到 87434 美元不等（平均 24869 美元）。所有手术旅行的总费用为 373040 美元。作者使用人力资本方法计算出 3576845 美元的净经济效益，使用生命统计年价值方法计算出 8650745 美元的净经济效益。
作者使用人力资本方法和生命统计年价值方法都发现了可观的投资回报。此外，作者发现强调教育的旅行具有净经济效益。成本效益分析具有重大的财务影响，并将帮助决策者制定降低成本的策略，以促进中低收入国家的手术。
