Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study
<p>Abstract</p> <p>Objective</p> <p>The study aims to investigate whether laparoscopic cholecystectomy (LC) is a cost-effective strategy for managing gallbladder-stone disease compared to the conventional open cholecystectomy(OC) in a Thai setting.</p> <p>De...
Main Authors: | , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2005-10-01
|
Series: | Cost Effectiveness and Resource Allocation |
Online Access: | http://www.resource-allocation.com/content/3/1/10 |
id |
doaj-330973d0bc0c452fa0d569e026316d6e |
---|---|
record_format |
Article |
spelling |
doaj-330973d0bc0c452fa0d569e026316d6e2020-11-24T21:53:58ZengBMCCost Effectiveness and Resource Allocation1478-75472005-10-01311010.1186/1478-7547-3-10Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case studyTeerawattananon YotMugford Miranda<p>Abstract</p> <p>Objective</p> <p>The study aims to investigate whether laparoscopic cholecystectomy (LC) is a cost-effective strategy for managing gallbladder-stone disease compared to the conventional open cholecystectomy(OC) in a Thai setting.</p> <p>Design and Setting</p> <p>Using a societal perspective a cost-utility analysis was employed to measure programme cost and effectiveness of each management strategy. The costs borne by the hospital and patients were collected from Chiang Rai regional hospital while the clinical outcomes were summarised from a published systematic review of international and national literature. Incremental cost per Quality Adjusted Life Year (QALY) derived from a decision tree model.</p> <p>Results</p> <p>The results reveal that at base-case scenario the incremental cost per QALY of moving from OC to LC is 134,000 Baht under government perspective and 89,000 Baht under a societal perspective. However, the probabilities that LC outweighed OC are not greater than 95% until the ceiling ratio reaches 190,000 and 270,000 Baht per QALY using societal and government perspective respectively.</p> <p>Conclusion</p> <p>The economic evaluation results of management options for gallstone disease in Thailand differ from comparable previous studies conducted in developed countries which indicated that LC was a cost-saving strategy. Differences were due mainly to hospital costs of post operative inpatient care and value of lost working time. The LC option would be considered a cost-effective option for Thailand at a threshold of three times per capita gross domestic product recommended by the committee on the Millennium Development Goals.</p> http://www.resource-allocation.com/content/3/1/10 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Teerawattananon Yot Mugford Miranda |
spellingShingle |
Teerawattananon Yot Mugford Miranda Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study Cost Effectiveness and Resource Allocation |
author_facet |
Teerawattananon Yot Mugford Miranda |
author_sort |
Teerawattananon Yot |
title |
Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study |
title_short |
Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study |
title_full |
Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study |
title_fullStr |
Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study |
title_full_unstemmed |
Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study |
title_sort |
is it worth offering a routine laparoscopic cholecystectomy in developing countries? a thailand case study |
publisher |
BMC |
series |
Cost Effectiveness and Resource Allocation |
issn |
1478-7547 |
publishDate |
2005-10-01 |
description |
<p>Abstract</p> <p>Objective</p> <p>The study aims to investigate whether laparoscopic cholecystectomy (LC) is a cost-effective strategy for managing gallbladder-stone disease compared to the conventional open cholecystectomy(OC) in a Thai setting.</p> <p>Design and Setting</p> <p>Using a societal perspective a cost-utility analysis was employed to measure programme cost and effectiveness of each management strategy. The costs borne by the hospital and patients were collected from Chiang Rai regional hospital while the clinical outcomes were summarised from a published systematic review of international and national literature. Incremental cost per Quality Adjusted Life Year (QALY) derived from a decision tree model.</p> <p>Results</p> <p>The results reveal that at base-case scenario the incremental cost per QALY of moving from OC to LC is 134,000 Baht under government perspective and 89,000 Baht under a societal perspective. However, the probabilities that LC outweighed OC are not greater than 95% until the ceiling ratio reaches 190,000 and 270,000 Baht per QALY using societal and government perspective respectively.</p> <p>Conclusion</p> <p>The economic evaluation results of management options for gallstone disease in Thailand differ from comparable previous studies conducted in developed countries which indicated that LC was a cost-saving strategy. Differences were due mainly to hospital costs of post operative inpatient care and value of lost working time. The LC option would be considered a cost-effective option for Thailand at a threshold of three times per capita gross domestic product recommended by the committee on the Millennium Development Goals.</p> |
url |
http://www.resource-allocation.com/content/3/1/10 |
work_keys_str_mv |
AT teerawattananonyot isitworthofferingaroutinelaparoscopiccholecystectomyindevelopingcountriesathailandcasestudy AT mugfordmiranda isitworthofferingaroutinelaparoscopiccholecystectomyindevelopingcountriesathailandcasestudy |
_version_ |
1725869757360504832 |