wow-inequalities/02-data/intermediate/wos_sample/b4eaa965544df2481de2a36038811b7b-silverstein-allison/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background Laparoscopic cholecystectomy is first-line treatment for
uncomplicated gallstone disease in high-income countries due to benefits
such as shorter hospital stays, reduced morbidity, more rapid return to
work, and lower mortality as well-being considered cost-effective.
However, there persists a lack of uptake in low- and middle-income
countries. Thus, there is a need to evaluate laparoscopic
cholecystectomy in comparison with an open approach in these settings.
Methods A cost-effectiveness analysis was performed to evaluate
laparoscopic and open cholecystectomies at Rwanda Military Hospital
(RMH), a tertiary care referral hospital in Rwanda. Sensitivity and
threshold analyses were performed to determine the robustness of the
results.
Results The laparoscopic and open cholecystectomy costs and
effectiveness values were \$2664.47 with 0.87 quality-adjusted life
years (QALYs) and \$2058.72 with 0.75 QALYs, respectively. The
incremental cost-effectiveness ratio for laparoscopic over open
cholecystectomy was \$4946.18. Results are sensitive to the initial
laparoscopic equipment investment and number of cases performed annually
but robust to other parameters. The laparoscopic intervention is more
cost-effective with investment costs less than \$91,979, greater than 65
cases annually, or at willingness-to-pay (WTP) thresholds greater than
\$3975/QALY.
Conclusions At RMH, while laparoscopic cholecystectomy may be a more
effective approach, it is also more expensive given the low caseload and
high investment costs. At commonly accepted WTP thresholds, it is not
cost-effective. However, as investment costs decrease and/or case volume
increases, the laparoscopic approach may become favorable. Countries and
hospitals should aspire to develop innovative, low-cost options in high
volume to combat these barriers and provide laparoscopic surgery.'
affiliation: 'Shrime, MG (Corresponding Author), Harvard Med Sch, Program Global Surg
\& Social Change, 641 Huntington Ave 411, Boston, MA 02115 USA.
Silverstein, Allison; Costas-Chavarri, Ainhoa; Mukhopadhyay, Swagoto; Meara, John
G.; Shrime, Mark G., Harvard Med Sch, Program Global Surg \& Social Change, 641
Huntington Ave 411, Boston, MA 02115 USA.
Silverstein, Allison, Univ Miami, Miller Sch Med, Miami, FL 33136 USA.
Costas-Chavarri, Ainhoa; Gakwaya, Mussa R.; Lule, Joseph, Rwanda Mil Hosp, Kigali,
Rwanda.
Mukhopadhyay, Swagoto, Univ Connecticut, Dept Surg, Farmington, CT USA.
Meara, John G., Boston Childrens Hosp, Dept Plast \& Oral Surg, Boston, MA USA.
Shrime, Mark G., Massachusetts Eye \& Ear Infirm, Dept Otolaryngol, Boston, MA 02114
USA.
Shrime, Mark G., Massachusetts Eye \& Ear Infirm, Off Global Surg, Boston, MA 02114
USA.'
author: Silverstein, Allison and Costas-Chavarri, Ainhoa and Gakwaya, Mussa R. and
Lule, Joseph and Mukhopadhyay, Swagoto and Meara, John G. and Shrime, Mark G.
author-email: shrime@mail.harvard.edu
author_list:
- family: Silverstein
given: Allison
- family: Costas-Chavarri
given: Ainhoa
- family: Gakwaya
given: Mussa R.
- family: Lule
given: Joseph
- family: Mukhopadhyay
given: Swagoto
- family: Meara
given: John G.
- family: Shrime
given: Mark G.
da: '2023-09-28'
doi: 10.1007/s00268-016-3851-0
eissn: 1432-2323
files: []
issn: 0364-2313
journal: WORLD JOURNAL OF SURGERY
keywords-plus: BILE-DUCT; HEALTH; SURGERY; RECOMMENDATIONS; BENEFITS; MEDICINE
language: English
month: MAY
number: '5'
number-of-cited-references: '34'
orcid-numbers: Meara, John G./0000-0003-4369-3209
pages: 1225-1233
papis_id: 5b89e1e69c8848606769e7f9347efeeb
ref: Silverstein2017laparoscopicopen
times-cited: '14'
title: 'Laparoscopic Versus Open Cholecystectomy: A Cost-Effectiveness Analysis at
Rwanda Military Hospital'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000399693400011
usage-count-last-180-days: '0'
usage-count-since-2013: '3'
volume: '41'
web-of-science-categories: Surgery
year: '2017'