The path to sustainable cardiac surgery in Rwanda: analysis of costs for consumables used during cardiac surgery for a non-governmental organization.

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Hannah Rando, Maurice Musoni, Bonnie C Greenwood, Lambert Ingabire, Sam Van Hook, Ceeya Patton Bolman, R Morton Bolman, Yihan Lin
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Abstract

Background: Until local healthcare infrastructure is strengthened, cardiac surgical care in low- and middle-income countries is often provided by non-governmental organizations by way of visiting healthcare teams. This is generally considered to be a cost-effective alternative to transporting patients to high income countries for surgical care, but the costs of cardiac surgery consumables under this model are poorly understood. Our objective was to identify the per-patient cost of cardiac surgery consumables used in single and double valve replacements performed by a non-governmental organization in Rwanda.

Methods: Financial data from 2020 were collected from Team Heart, a non-governmental organization that supports cardiac surgical care in Rwanda. A comprehensive list of consumables was generated, including surgical, perfusion, anesthesia, and inpatient supplies and medications. Acknowledging the variability in perioperative needs, the quantities of consumables were calculated from an average of six patients who underwent single or double-valve replacement in 2020. Total costs were calculated by multiplying purchasing price by average quantity per patient. Costs absorbed by the local hospital were excluded from the calculations.

Results: The total cost per patient was estimated at $9,450. Surgical supplies comprised the majority of costs ($6,140 per patient), with the most substantial cost being that of replacement valves ($3,500 per valve), followed by surgical supplies ($1,590 per patient).

Conclusions: This preliminary analysis identifies a cost of just over $9,000 per patient for consumables used in cardiac valve surgery in Rwanda, which is lower than the estimated costs of transporting patients to centers in high income countries. This work highlights the relative cost effectiveness of cardiac surgical care in low- and middle- income countries under this model and will be instrumental in guiding the allocation of local and international resources in the future.

卢旺达心脏外科手术的可持续发展之路:对一家非政府组织心脏外科手术期间所用消耗品的成本分析。
背景:在当地医疗基础设施得到加强之前,中低收入国家的心脏外科护理通常由非政府组织通过巡回医疗小组的方式提供。人们普遍认为,与将病人运送到高收入国家接受手术治疗相比,这是一种具有成本效益的替代方式,但人们对这种模式下心脏手术耗材的成本却知之甚少。我们的目标是确定卢旺达一家非政府组织在单瓣膜和双瓣膜置换术中使用的心脏手术耗材的人均成本:方法:我们从支持卢旺达心脏手术治疗的非政府组织 Team Heart 收集了 2020 年的财务数据。编制了一份全面的消耗品清单,包括手术、灌注、麻醉和住院患者的用品和药物。考虑到围术期需求的差异性,耗材数量是根据 2020 年接受单瓣膜或双瓣膜置换术的六名患者的平均数量计算得出的。总成本通过采购价格乘以每位患者的平均数量计算得出。计算结果不包括当地医院承担的费用:每位患者的总成本估计为 9450 美元。手术用品占大部分成本(每位患者 6,140 美元),其中更换瓣膜的成本最高(每个瓣膜 3,500 美元),其次是手术用品(每位患者 1,590 美元):这项初步分析表明,在卢旺达,每名患者在心脏瓣膜手术中使用的耗材成本略高于 9,000 美元,低于将患者运送到高收入国家的中心所需的估计成本。这项工作凸显了在这种模式下,中低收入国家心脏外科护理的相对成本效益,将有助于指导未来当地和国际资源的分配。
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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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