Cost/DALY Averted in a Small Hospital in Sierra Leone: What Is the Relative Contribution of Different Services?
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A cost-effective analysis (CEA) can be a useful tool to guide resource allocation decisions. However, there is a dearth of evidence on the cost/disability-adjusted life year (DALY) averted by health facilities in the developing world.
We conducted a study to calculate the costs and the DALYs averted by an entire hospital in Sierra Leone, using the method suggested by McCord and Chowdhury (Int J Gynaecol Obstet 2003;81:83–92).
For the 3-month study period, total costs were calculated to be $369,774. Using the approach of McCord and Chowdhury, we calculated that 11,282 DALYs were averted during the study period, resulting in a cost/DALY averted of $32.78. This figure compares favorably to other non-surgical health interventions in developing countries. We found that while surgery accounts for 63% of total caseload, it contributes to 38% of the total DALYs averted.
Surgical treatment of some common pathologies in developing countries may be more cost-effective than previously thought, and our results provide evidence for the inclusion of surgery as part of the basic public health armamentarium in developing countries. However, these results are highly context-specific, and more research is needed from developing countries to further refine the methodology and analysis.
KeywordsInguinal Hernia Oral Rehydration Solution Resource Allocation Decision Monthly Cost Pediatric Service
- 1.Adam T, Baltussen R, Tan Torres T, et al. Making Choices in Health: WHO Guide to Cost Effectiveness Analysis. Geneva, World Health Organization, 2003Google Scholar
- 5.Jamison D, Evans D, Alleyne G, et al., editors. Disease Control Priorities in Developing Countries. 2nd ed. Washington, DC, World Bank, Forthcoming 2006Google Scholar
- 7.Jamison DT, International Bank for Reconstruction and Development. Disease Control Priorities in Developing Countries. New York, Oxford University Press for the World Bank, 1993Google Scholar
- 11.Shepard D, Walsh J, Munar W, et al. Cost-effectiveness of ambulatory surgery in Cali, Colombia. Health Policy Plan 1993;8:136–142Google Scholar
- 14.Murray CJL, Lopez AD, Harvard School of Public Health, World Health Organization., World Bank. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard School of Public Health for the World Health Organization and the World Bank; Distributed by Harvard University Press, 1996Google Scholar