Femur Bone Fracture Treatment in Addis Ababa, Ethiopia: A cost-effectiveness Analysis
Not peer reviewed
MetadataShow full item record
Introduction: Surgically treatable conditions represent about 11 % of the world’s Disability Adjusted Life Years (DALYs) lost. Cost-effectiveness analyses for trauma show that surgical interventions are more cost effective as compared to non-surgical interventions. The objective of this study is to do a health economic evaluation of orthopedic treatment of femur bone fracture by comparing traction and Intramedullary Nail (IMN) for patients treated at a tertiary and general hospitals in Addis Ababa, Ethiopia. Method: Direct out of pocket expenditures that were included are cost of hospitals bed day, drugs, investigations and physiotherapy. Patients’ medical record was used to extract the type and number of investigations ordered and medications given. Expenditures were estimated by multiplying the number of investigations and medicines reported by each patient by their prices as given by the price-list of service fees set by the hospitals. The unit cost of health worker per treated patient was calculated by multiplying the time spent to treat a patient by salary rate per hour of health professionals. Patients were interviewed about their functional status using a structured questionnaire. Their health status was then used to select disability weights as given by the Global Burden of Disease Study, and further used to estimate health outcomes as Health Adjusted Life Years (HALY). A societal cost perspective has been used, and health benefits were calculated over a lifetime. Results: The direct out of pocket expenditure for the traction treatment group was 6,262 USD (132,754 ETB). Cost per patient is 250 USD (5,310 ETB). Provider costs for the traction treatment group was 1,562 USD (33,114 ETB) and total cost was 7824 USD (165,869 ETB). The direct out of pocket expenditure for the IMN treatment group was 4,849 USD (102,804 ETB). Cost per patient was 194 USD (4,112 ETB). Provider costs for the IMN treatment group was 6,112 USD (129,574 ETB) and total costs was 10,961 USD (232,373 ETB). The net discounted HALY gained in the traction treatment group was 16.2 and the net discounted HALY gained in the IMN group was 33.6. The average cost-effectiveness ratio (ACER) for the traction group was 483 USD/HALY gained and for the IMN treatment group it was 326 3 USD/HALY gained. Therefor the incremental cost of going from traction to IMN treatment group was 3,137 USD and the incremental health gain was 17 HALYs. The incremental costeffectiveness ratio was 180 USD per HALY gained. Conclusion: This study has shown that IMN is more cost effective than traction for the treatment of femur bone fracture treatment.
PublisherThe University of Bergen
Copyright the Author. All rights reserved