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Arch Surg. 2010 Oct;145(10):954-61. doi: 10.1001/archsurg.2010.208.

Cost-effectiveness of groin hernia surgery in the Western Region of Ghana.

Author information

1
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Abstract

OBJECTIVE:

To calculate the cost-effectiveness of tension-free inguinal hernia repair with mosquito net mesh in the Western Region of Ghana.

DESIGN:

Prospective study.

SETTING:

Four district hospitals in the Western Region of Ghana.

PATIENTS:

A total of 113 referred or presenting patients from rural areas with inguinal hernias of various sizes.

INTERVENTION:

Lichtenstein method of tension-free repair using mosquito net mesh by European and African surgeons. Main Outcome Measure Disability-adjusted life-years (DALYs) averted with counterfactual definitions based on precedent and expert opinion.

RESULTS:

All operations were performed as day cases, with 81 of the patients (71.7%) under local anesthesia and few complications. An average of 9.3 (95% confidence interval [CI], 8.0-10.7) DALYs were averted per person, with a total of 1052 averted in the study. Average cost per patient was $120.02 (95% CI, $117.66-$122.39) from a provider perspective and $102.88 ($88.47-$117.29) from a patient perspective. Cost-effectiveness was $12.88 per DALY averted (95% CI, $10.98-$14.78), which is well below the Ghanaian per capita gross national income ($590). Results were robust to sensitivity analysis and may be refined as further work is done on the burden of disease due to hernias in Africa.

CONCLUSIONS:

Inguinal hernia repair was cost-effective in the Western Region of Ghana through international collaboration. Research in other settings should test the generalizability of results.

PMID:
20956763
DOI:
10.1001/archsurg.2010.208
[Indexed for MEDLINE]

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