Economic impact of surgery on households and individuals in low income countries: A systematic review.

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  • Additional Information
    • Source:
      Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101228232 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1743-9159 (Electronic) Linking ISSN: 17439159 NLM ISO Abbreviation: Int J Surg Subsets: MEDLINE
    • Publication Information:
      Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc.
      Original Publication: London : Surgical Associates Ltd., c2004-
    • Subject Terms:
      Poverty*; Developing Countries/*economics ; Health Services Accessibility/*economics ; Surgical Procedures, Operative/*economics; Child ; Cross-Sectional Studies ; Economic Factors ; Humans ; Universal Health Insurance
    • Abstract:
      Background: Surgical disease in Low Income Countries (LIC) is common, and overall provision of surgical care is poor. A key component of surgical health systems as part of universal health coverage (UHC) is financial risk protection (FRP) - the need to protect individuals from financial hardship due to accessing healthcare. We performed a systematic review to amalgamate current understanding of the economic impact of surgery on the individual and household. Our study was registered on Research registry (www.researchregistry.com).
      Methods: We searched Pubmed and Medline for articles addressing economic aspects of surgical disease/care in low income countries. Data analysis was descriptive in light of a wide range of methodologies and reporting measures. Quality assessment and risk of bias analysis was performed using study design specific Joanna-Briggs Institute checklists. This study has been reported in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) Guidelines.
      Results: 31 full text papers were identified for inclusion; 22 descriptive cross-sectional studies, 4 qualitative studies and 5 economic analysis studies of varying quality. Direct medical, direct non-medical and indirect costs were variably reported but were substantial, resulting in catastrophic expenditure. Costs had far reaching economic impacts on individuals and households, who used entire savings, took out loans, reduced essential expenditure and removed children from school to meet costs.
      Conclusion: Seeking healthcare for surgical disease is economically devastating for individuals and households in LICs. Policies directed at strengthening surgical health systems must seek ways to reduce financial hardship on individuals and households from both direct and indirect costs and these should be monitored and measured using defined instruments from the patient perspective.
      (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
    • Comments:
      Comment in: Int J Surg. 2021 Jul;91:105991. (PMID: 34118438)
    • Contributed Indexing:
      Keywords: Catastrophic health expenditure; Economics; Low income countries; Out-of-pocket expenditure; Surgical disease; Surgical procedures
    • Publication Date:
      Date Created: 20210503 Date Completed: 20210706 Latest Revision: 20210823
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.ijsu.2021.105956
    • Accession Number:
      33940199