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Estimation of Impact of Surgical Disease Through Economic Modeling of Cleft Lip and Palate Care

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Abstract

Background

Assessing burden of disease encompasses the prevalence of disease entities, but it is the impact that affects the populace. Similarly, optimal evaluation of intervention programs shows impact rather than simply an enumeration of services. Economic effects are a fungible measure but are difficult to assess. Modeling of economic effects was used to evaluate a cleft program in Nepal and to demonstrate impact of alleviating this subset of the surgical burden of disease.

Methods

The database of patients who underwent care at a cleft center in Katmandu in 2005 was used. Disability adjusted life years averted were calculated. Using both GNI per capita and Value of a Statistical Life, the economic value to the individuals and to society was calculated.

Results

The two methods yielded a conservative and a generous estimate of economic impact of treating cleft lip and palate. Using GNI per capita, cleft lip repair added between $856 and $6,598 to lifetime individual income. For cleft palate, this ranged from $2,293 to $17,278. Using Value of a Statistical Life, cleft lip repair added between $56,919 and $143,363, and cleft palate between $152,372 and $375,412.

Conclusions

The immense economic gain realized by an intervention addressing a small proportion of the surgical burden of disease indicates the importance of these conditions to public health and well-being. This methodology also lends itself to broader use and to further refinement as a means of evaluation of interventions. This has implications for health policy and for funding and resource allocation for surgical conditions in the developing world.

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Notes

  1. Purchasing Power Parity considers the varying prices of goods between national economies; the Atlas method of computing Gross National Income measures income in terms of currency equivalents, but also considers fluctuations in exchange rates. See http://www.who.int/choice/costs/ppp/en/ for more information on PPP and http://web.worldbank.org/WBSITE/EXTERNAL/DATASTATISTICS/0,,contentMDK:20173256~isCURL:Y~menuPK:64133156~pagePK:64133150~piPK:64133175~theSitePK:239419,00.html for more information on economic assessment of countries.

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Acknowledgments

The author acknowledges the contributions to this work of Dr. Shankar Man Rai and Dr. Kiran Nakarmi of the Interplast Surgical Outreach Program at Katmandu Model Hospital, Katmandu, Nepal.

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  1. Interplast, 857 Maude Avenue, Mountain View, CA, 94043, USA

    D. Scott Corlew

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  1. D. Scott Corlew
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Correspondence to D. Scott Corlew.

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Corlew, D.S. Estimation of Impact of Surgical Disease Through Economic Modeling of Cleft Lip and Palate Care. World J Surg 34, 391–396 (2010). https://doi.org/10.1007/s00268-009-0198-9

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