Nader Fasseeh Ahmad, Salem Amany Ahmed, Khalifa Ahmed Yehia, ElBerri Asmaa Khairy, Abaza Nada, Elezbawy Baher, Al Qasseer Naeema, Nagy Balázs, Kaló Zoltán, Németh Bertalan, Hren Rok
Syreon Middle East, Alexandria 5424041, Egypt.
Faculty of Pharmacy, Alexandria University, Alexandria 5424041, Egypt.
Healthcare (Basel). 2025 Jul 7;13(13):1619. doi: 10.3390/healthcare13131619.
Reducing waiting times for elective surgeries remains a critical global healthcare challenge that negatively impacts patient outcomes and economic productivity. This study develops an adaptable cost-utility modeling framework for assessing the cost-effectiveness (CE) of reducing waiting time for elective surgeries in data-limited environments. We evaluated the economic and health impacts of Egypt's recent initiative aimed at decreasing surgical waiting lists. The study conducts a CE analysis of the initiative by estimating incremental costs (expressed in Egyptian Pounds-EGP) and outcomes (expressed in quality-adjusted life years-QALYs) before and after its implementation, performs a benefit-cost analysis to quantify the initiative's return on investment, and employs a budget share method to evaluate catastrophic health expenditure (CHE). The analysis included five elective surgical interventions: open-heart surgery, cardiac catheterization, cochlear implantation, ophthalmic surgery, and orthopedic (joint replacement) surgery. The main research outcomes of the study are as follows. The initiative resulted in incremental cost-effectiveness ratios of EGP 46,795 (societal perspective) and EGP 56,094 (payer perspective) per QALY, both within acceptable CE thresholds. Most of the evaluated interventions demonstrated substantial returns on the investment. Without public funding, more than 90% of patients faced CHE, indicating considerable financial barriers to elective surgeries. Egypt's initiative to reduce waiting times was deemed cost-effective. Our adaptable modeling framework could be practical for similar evaluations in low/middle-income countries, especially where data is limited. Scaling up the initiative to include additional curative and preventive services and integrating it with broader health system reforms in Egypt is strongly recommended.
减少择期手术的等待时间仍然是一项严峻的全球医疗挑战，对患者预后和经济生产力产生负面影响。本研究开发了一个适应性成本效用建模框架，用于评估在数据有限的环境中减少择期手术等待时间的成本效益（CE）。我们评估了埃及最近旨在减少手术等待名单的举措所产生的经济和健康影响。该研究通过估计该举措实施前后的增量成本（以埃及镑-EGP表示）和结果（以质量调整生命年-QALYs表示），对该举措进行了CE分析，进行了效益成本分析以量化该举措的投资回报率，并采用预算份额法评估灾难性卫生支出（CHE）。分析包括五项择期手术干预：心脏直视手术、心导管插入术、人工耳蜗植入、眼科手术和骨科（关节置换）手术。该研究的主要研究结果如下。该举措导致每QALY的增量成本效益比为46,795埃及镑（社会视角）和56,094埃及镑（支付方视角），均在可接受的CE阈值范围内。大多数评估的干预措施都显示出可观的投资回报。如果没有公共资金，超过90%的患者面临CHE，这表明择期手术存在相当大的经济障碍。埃及减少等待时间的举措被认为具有成本效益。我们的适应性建模框架对于低收入/中等收入国家的类似评估可能是实用的，特别是在数据有限的情况下。强烈建议扩大该举措，纳入更多的治疗和预防服务，并将其与埃及更广泛的卫生系统改革相结合。
