Table 3. Cost-Effectiveness Ratios of Pediatric Surgical Procedures.
| Intervention | Location | Cost-effectiveness ratio, as reporteda | Unit of outcome | Cost-effectiveness ratio, 2015 USDb | ||
|---|---|---|---|---|---|---|
| Cardiac Surgery | ||||||
| Costa et al (2014) [94] | Atrial septal defects: percutaneous | Brazil | R$976 | QALY, average | $553 | |
| R$230,641 | QALY, incremental | $123,550 | ||||
| Atrial septal defects: surgical | R$631 | QALY, average | $357 | |||
| Ear, Nose & Throat | ||||||
| Wu et al (2013) [44] | Various ENT procedures | Kenya | $42–95 | DALY, average | $44–100 | |
| General Surgery | ||||||
| Jha et al (1998) [29] | Appendectomye | Guinea | $36 | LYS, average | $58 | |
| Inguinal hernia repaire | $74 | LYS, average | $119 | |||
| Gosselin et al (2006) [26] | Various general surgery | Sierra Leone | $33 | DALY, average | $41 | |
| Shillcutt et al (2010) [36] | Inguinal hernia repair | Ghana | $11–15 | DALY, incremental | $12–16 | |
| Wang et al (2012) [97] | Cystic echinococcosis | China | $1,469 | DALY, average | $1,628 | |
| Ilbawi et al (2013) [50] | Various general surgery | Cameroon | $21–147 | DALY, average | $24–169 | |
| Shillcutt et al (2013) [38] | Inguinal hernia repair | Ecuador | $44–123 | DALY, incremental | $47–131 | |
| Wu et al (2013) [44] | Various general surgery | Kenya | $50–110 | DALY, average | $53–116 | |
| Eeson et al (2015) [39] | Inguinal hernia repair | Uganda | $3–12 | DALY, incremental | $4–14 | |
| Neurosurgery | ||||||
| Warf et al (2011) [66] | Hydrocephalus | Uganda | $59–126 | DALY, average | $72–153 | |
| Wu et al (2013) [44] | Various neurological operations | Kenya | $26–65 | DALY, average | $27–69 | |
| Davis et al (2014) [57] | Various neurological operations | Guatemala | $385 | DALY, average | $387 | |
| Ophthalmology | ||||||
| Evans et al (1996) [54] | Trichiasis surgery | Burma | $59 | HALY, average | $107 | |
| $10 | HALY, incremental | $18 | ||||
| Baltussen et al (2005) [55] | Trichiasis surgery | Africa | $13–17 | DALY, average | $18–23 | |
| Americas | $49 | DALY, average | $68 | |||
| Mediterranean | $36–78 | DALY, average | $50–108 | |||
| Southeast Asia | $24 | DALY, average | $33 | |||
| Western Pacific | $35 | DALY, average | $48 | |||
| Baltussen et al (2012) [56] | Trichiasis surgery | Sub-Saharan Africa | $71–189 | DALY, incremental | $86–230 | |
| Trichiasis surgery | $71–90 | DALY, average | $86–110 | |||
| Cataract repair | $116–117 | DALY, incremental | $141–142 | |||
| Cataract repair | $116 | DALY, average | $141 | |||
| Trichiasis surgery | Southeast Asia | $285–849 | DALY, incremental | $347–1,034 | ||
| Trichiasis surgery | $285–374 | DALY, average | $347–455 | |||
| Cataract repair | $97 | DALY, incremental | $118 | |||
| Cataract repair | $97 | DALY, average | $118 | |||
| Orthopedics | ||||||
| Grimes et al (2014) [67] | Various orthopedic procedures | Malawi | $92–139 | DALY, average | $95–144 | |
| Gosselin et al (2008) [69] | Various orthopedic procedures | Cambodia | $77 | DALY, average | $92 | |
| Gosselin et al (2011) [72] | Various orthopedic procedures | Nicaragua | $362 | DALY, average | $395 | |
| Dominican Repub. | $362 | DALY, average | $395 | |||
| Haiti | $343 | DALY, average | $374 | |||
| Chen et al (2012) [73] | Various orthopedic procedures | Nicaragua | $270–719 | DALY, incremental | $295–787 | |
| Wu et al (2013) [44] | Various orthopedic procedures | Kenya | $34–72 | DALY, average | $36–76 | |
| Plastic and Reconstructive Surgery | ||||||
| Corlew (2010) [60] | Cleft lip & palate | Nepal | $29–73 | DALY, average | $35–89 | |
| Magee Jr. et al (2010) [61] | Cleft lip & palate | Vietnam | $7–850 | DALY, average | $8–939 | |
| Nicaragua | $66–1,828 | DALY, average | $73–2,019 | |||
| Kenya | $96–1,193 | DALY, average | $106–1,318 | |||
| Moon et al (2012) [64] | Cleft lip & palate | Vietnam | $43–97 | DALY, average | $47–106 | |
| Poenaru (2013) [65] | Cleft lip & palate | Africa | $72–134 | DALY, average | $79–146 | |
| Americas | $35–85 | DALY, average | $38–93 | |||
| Europe | $35–89 | DALY, average | $38–97 | |||
| Middle East | $42–100 | DALY, average | $46–109 | |||
| Southeast Asia | $44–102 | DALY, average | $48–112 | |||
| Western Pacific | $35–87 | DALY, average | $38–95 | |||
| Rattray et al (2013) [43] | Various reconstructive procedures | Cambodia | $99 | DALY, average | $103 | |
| Wu et al (2013) [44] | Various reconstructive procedures | Kenya | $35–79 | DALY, average | $37–84 | |
| Urology | ||||||
| Binagwaho et al (2010) [45] | Circumcision | Rwanda | $334 | LYG, incremental | $370 | |
| Wu et al (2013) [44] | Various urologic operations | Kenya | $56–119 | DALY, average | $59–126 | |
Abbreviations include: DALY disability-adjusted life-year; LYS life-year saved; LYG life-years gained; HALY health-adjusted life-year; QALY quality-adjusted life-year; USD United States dollar; Int. $ International dollars (a hypothetical currency unit with the same purchasing power parity that the U.S. dollar has in the United States at a given time).
a All values presented on a per-procedure basis.