Macroeconomic costs of the unmet burden of surgical disease in Sierra Leone: a retrospective economic analysis.

Autor:	Grimes CE; King's Centre for Global Health and Health Partnerships, King's College London and King's Health Partners, Weston Education Centre, London, UK.; Colorectal Surgery, Medway NHS Foundation Trust, Gillingham, United Kingdom., Quaife M; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK., Kamara TB; Department of Surgery, College of Medicine and Allied Health Sciences, Freetown, Sierra Leone.; Department of Surgery, Connaught Hospital, Freetown, Sierra Leone., Lavy CBD; Department of Orthopaedics and Tropical Surgery, Oxford University, Oxford, UK., Leather AJM; King's Centre for Global Health and Health Partnerships, King's College London and King's Health Partners, Weston Education Centre, London, UK., Bolkan HA; Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.; Department of Surgery, St Olav's Hospital, Trondheim, Norway.; CapaCare, Trondheim, Norway.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2018 Mar 14; Vol. 8 (3), pp. e017824. Date of Electronic Publication: 2018 Mar 14.
DOI:	10.1136/bmjopen-2017-017824
Abstrakt:	Objectives: The Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US$12.3 trillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist. We aimed to estimate the costs to the Sierra Leone economy from death and disability which may have been averted by surgical care. Design: We used estimates of total, met and unmet need from two main sources-a cluster randomised, cross-sectional, countrywide survey and a retrospective, nationwide study on surgery in Sierra Leone. We calculated estimated disability-adjusted life years from morbidity and mortality for the estimated unmet burden and modelled the likely economic impact using three different methods-gross national income per capita, lifetime earnings foregone and value of a statistical life. Results: In 2012, estimated, discounted lifetime losses to the Sierra Leone economy from the unmet burden of surgical disease was between US$1.1 and US$3.8 billion, depending on the economic method used. These lifetime losses equate to between 23% and 100% of the annual GDP for Sierra Leone. 80% of economic losses were due to mortality. The incremental losses averted by scale up of surgical provision to the Lancet Commission target of 80% were calculated to be between US$360 million and US$2.9 billion. Conclusion: There is a large economic loss from the unmet need for surgical care in Sierra Leone. There is an immediate need for massive investment to counteract ongoing economic losses. Competing Interests: Competing interests: None declared. (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
Databáze:	MEDLINE
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