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Economic evaluation of expanding inguinal hernia repair among adult males in Ghana

An unmet need for inguinal hernia repair is significant in Ghana where the number of specialist general surgeons is extremely limited. While surgical task sharing with medical doctors without formal specialist training in surgery has been adopted for inguinal hernia repair in Ghana, no prior researc...

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Autores principales: Thet Lwin, Zin Min, Forsberg, Birger, Keel, George, Beard, Jessica H., Amoako, Joachim, Ohene-Yeboah, Michael, Tabiri, Stephen, Löfgren, Jenny
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022161/
https://www.ncbi.nlm.nih.gov/pubmed/36962172
http://dx.doi.org/10.1371/journal.pgph.0000270
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author Thet Lwin, Zin Min
Forsberg, Birger
Keel, George
Beard, Jessica H.
Amoako, Joachim
Ohene-Yeboah, Michael
Tabiri, Stephen
Löfgren, Jenny
author_facet Thet Lwin, Zin Min
Forsberg, Birger
Keel, George
Beard, Jessica H.
Amoako, Joachim
Ohene-Yeboah, Michael
Tabiri, Stephen
Löfgren, Jenny
author_sort Thet Lwin, Zin Min
collection PubMed
description An unmet need for inguinal hernia repair is significant in Ghana where the number of specialist general surgeons is extremely limited. While surgical task sharing with medical doctors without formal specialist training in surgery has been adopted for inguinal hernia repair in Ghana, no prior research has been conducted on the long-term costs and health outcomes associated with expanding operations to repair all inguinal hernias among adult males in Ghana. The study aimed to estimate cost-effectiveness of elective open mesh repair performed by medical doctors and surgeons for adult males with primary inguinal hernia compared to no treatment in Ghana and to project costs and health gains associated with expanding operation services through task sharing between medical doctors and surgeons. The study analysis adopted a healthcare system perspective. A Markov model was constructed to assess 10-year differences in costs and outcomes between operations conducted by medical doctors or surgeons and no treatment. A 10-year budget impact analysis on service expansion for groin hernia repair through increasing task sharing between the providers was conducted. Incremental cost-effectiveness ratios for medical doctors and surgeons were USD 120 and USD 129 respectively per disability-adjusted life year (DALY) averted compared to no treatment, which are below the estimated threshold value for cost-effectiveness in Ghana of USD 371–491. Repairing all inguinal hernias (1.4 million) through task sharing between the providers in the same timeframe is estimated to cost USD 194 million. Total health gains of 1.5 million DALYs averted are expected. Inguinal hernia repair is cost-effective regardless of the type of surgical provider. Scaling up of inguinal hernia repair is worthwhile, with the potential to substantially reduce the disease burden in the country.
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spelling pubmed-100221612023-03-17 Economic evaluation of expanding inguinal hernia repair among adult males in Ghana Thet Lwin, Zin Min Forsberg, Birger Keel, George Beard, Jessica H. Amoako, Joachim Ohene-Yeboah, Michael Tabiri, Stephen Löfgren, Jenny PLOS Glob Public Health Research Article An unmet need for inguinal hernia repair is significant in Ghana where the number of specialist general surgeons is extremely limited. While surgical task sharing with medical doctors without formal specialist training in surgery has been adopted for inguinal hernia repair in Ghana, no prior research has been conducted on the long-term costs and health outcomes associated with expanding operations to repair all inguinal hernias among adult males in Ghana. The study aimed to estimate cost-effectiveness of elective open mesh repair performed by medical doctors and surgeons for adult males with primary inguinal hernia compared to no treatment in Ghana and to project costs and health gains associated with expanding operation services through task sharing between medical doctors and surgeons. The study analysis adopted a healthcare system perspective. A Markov model was constructed to assess 10-year differences in costs and outcomes between operations conducted by medical doctors or surgeons and no treatment. A 10-year budget impact analysis on service expansion for groin hernia repair through increasing task sharing between the providers was conducted. Incremental cost-effectiveness ratios for medical doctors and surgeons were USD 120 and USD 129 respectively per disability-adjusted life year (DALY) averted compared to no treatment, which are below the estimated threshold value for cost-effectiveness in Ghana of USD 371–491. Repairing all inguinal hernias (1.4 million) through task sharing between the providers in the same timeframe is estimated to cost USD 194 million. Total health gains of 1.5 million DALYs averted are expected. Inguinal hernia repair is cost-effective regardless of the type of surgical provider. Scaling up of inguinal hernia repair is worthwhile, with the potential to substantially reduce the disease burden in the country. Public Library of Science 2022-04-04 /pmc/articles/PMC10022161/ /pubmed/36962172 http://dx.doi.org/10.1371/journal.pgph.0000270 Text en © 2022 Thet Lwin et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Thet Lwin, Zin Min
Forsberg, Birger
Keel, George
Beard, Jessica H.
Amoako, Joachim
Ohene-Yeboah, Michael
Tabiri, Stephen
Löfgren, Jenny
Economic evaluation of expanding inguinal hernia repair among adult males in Ghana
title Economic evaluation of expanding inguinal hernia repair among adult males in Ghana
title_full Economic evaluation of expanding inguinal hernia repair among adult males in Ghana
title_fullStr Economic evaluation of expanding inguinal hernia repair among adult males in Ghana
title_full_unstemmed Economic evaluation of expanding inguinal hernia repair among adult males in Ghana
title_short Economic evaluation of expanding inguinal hernia repair among adult males in Ghana
title_sort economic evaluation of expanding inguinal hernia repair among adult males in ghana
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022161/
https://www.ncbi.nlm.nih.gov/pubmed/36962172
http://dx.doi.org/10.1371/journal.pgph.0000270
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