The cost-effectiveness of orthopaedic clinical officers in Malawi-Reference-Cited by-同舟云学术

The cost-effectiveness of orthopaedic clinical officers in Malawi

Published:2014-05-12 Issue:3 Volume:44 Page:128-134
ISSN:0049-4755
Container-title:Tropical Doctor
language:en
Short-container-title:Trop Doct

Author:

Grimes Caris E¹,Mkandawire Nyengo C²,Billingsley Michael L³,Ngulube Christopher⁴,Cobey James C⁵

Affiliation:

1. Global Surgery Associate, Kings Centre for Global Health, Kings College London and King’s Health Partners, London, UK

2. Professor Orthopaedics and Head of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi; Clinical Director, OCO Training Programme, Malawi College of Health Sciences, Blantyre Campus, Blantyre, Malawi; Adjunct Professor, School of Medicine, Flinders University, Adelaide, South Australia

3. Medical Student, St George’s, University of London, London, UK

4. Principal Instructor for Malawi Orthopaedic Clinical Officer Program, Malawi College of Health Sciences, Blantyre Campus, Blantyre, Malawi

5. Senior Associate, Johns Hopkins Bloomberg School of Public Health, Clinical Professor of Orthopaedics, Georgetown School of Medicine, Washington, DC, USA

Abstract

Background In Malawi the orthopaedic clinical officer (OCO) training programme trains non-physician clinicians in musculoskeletal care. We studied the cost-effectiveness of this program. Methods Hospital logbooks were reviewed for data pertaining to activity in seven district hospitals over a 6-month period. The total costs were divided by the total effectiveness, calculated as disability adjusted life years (DALYs) averted. Results The total cost-effectiveness of providing orthopaedic care through the OCO training programme was US$92.06 per DALY averted. The mean per hospital was US$138.75 (95% CI: US$69.58–207.91) per DALY averted which is very cost-effective when compared with other health interventions. Of the 837 patients treated 63% were aged <15 years and 36% were in the ‘economically active’ demographic of ages 15–74 years. Conclusion Training of clinical officers in orthopaedic surgery is very cost-effective and allows transfer of skills into rural areas. The demographics suggest that failure to provide such care would have a negative economic impact.

Publisher

SAGE Publications

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health

Link

http://journals.sagepub.com/doi/pdf/10.1177/0049475514535575

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