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The Direct Medical Cost of Acute Appendicitis Surgery in a Resource-Limited Setting of Papua New Guinea

  • Surgery in Low and Middle Income Countries
  • Published:
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Abstract

Background

Acute appendicitis is a common surgical emergency, and challenges in access to surgery in a low middle-income country can direct cost implications.

Methods

A prospective cost of illness study was conducted at Alotau Provincial Hospital (APH) from October 14, 2019, to June 1, 2020. A bottom-up approach of microcosting was used to estimate the direct medical cost of consecutive patients with acute appendicitis undergoing surgery.

Results

The mean cost of acute appendicitis surgery for each patient was K39,517.66 (US$11,460.12) for uncomplicated appendicitis, K45,873.99 (US$13,303.46) for complicated appendicitis and K38,838.80 (US$ 11,263.25) for a normal appendix. In total, the direct medical cost for acute appendicitis in this study was K4,562,625.29 (US$ 1,323,161.33) with the majority of expenditure incurred by surgical ward expenses.

Conclusion

This study demonstrates that direct medical costs for uncomplicated appendicitis surgery in a resource-limited hospital are less expensive. As the pathology progresses, the cost also exponentially increases. Policy makers and clinicians must establish appropriate curative surgical services at secondary (NOM of acute appendicitis and laparoscopic surgery) and primary health-care levels to address acute appendicitis surgery as this can reduce costs.

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Acknowledgements

The authors would like to thank: Dr Morewaya chairman of the ethics committee of MBPHA, Dr Ikasa, Dr Bochem, Dr Inaido and HEO Didilemu of the surgical division of APH for their support and cooperation during the study, Dr Andrews, Dr Okaipa, Dr Pangiau, Mr Roidi and Mr Wolly of the Anesthetic division of APH for their support and cooperation during this study, Mr. Patrick, Mr. Marona and Mr. Wariupa of the nursing division of Alotau Provincial Hospital for their cooperation in the study, Ms. Stella Iwais of the office of Policy, Planning and Coordination, MPHA for providing the hospital fees and staff salaries, Mr Charles Malaibe and Mr Arnold Mera from PNG Power for assisting with electricity costs.

Funding

There was no funding for this study.

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Authors and Affiliations

  1. Surgical Department, Alotau Provincial Hospital, Milne Bay Provincial Health Authority, Alotau, Papua New Guinea

    Ian Umo & Kennedy James

Authors
  1. Ian Umo
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  2. Kennedy James
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Contributions

The design, data collection, analysis and write-up were done by Dr Umo. The study idea and contribution to write-up were done by Dr James.

Corresponding author

Correspondence to Ian Umo.

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Umo, I., James, K. The Direct Medical Cost of Acute Appendicitis Surgery in a Resource-Limited Setting of Papua New Guinea. World J Surg 45, 3558–3564 (2021). https://doi.org/10.1007/s00268-021-06290-2

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  • DOI: https://doi.org/10.1007/s00268-021-06290-2

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