Abstract：
BACKGROUND:Operative interventions have traditionally been seen as expensive; therefore, surgery has been given low priority in global health care planning in low-income countries. A growing body of evidence indicates that surgery can also be highly cost effective in low-income settings, but our current knowledge of the actual cost of surgery in such settings is limited. This study was carried out to obtain data on the costs of commonly performed operative procedures in a rural/semiurban setting in eastern Uganda. METHODS:A prospective, facility-based study carried out at a general district hospital (public) and a mission hospital (private, not-for-profit) in the Iganga and Mayuge districts in eastern Uganda. Items included in the cost calculations were staff time, materials and medicines, overhead costs, and capital costs. RESULTS:The cost of surgery was higher at the mission hospital, with higher expenditure and lower productivity than the public hospital. The most commonly performed major procedures were caesarean section, uterine evacuation, and herniorrhaphy for groin hernia. The costs for these interventions varied between $68.4 and $74.4, $25.0 and $32.6, and $58.6 and $66.0, respectively. The most commonly performed minor procedures were circumcision, suture of cuts and lacerations, and incision and drainage of abscess. The costs for these interventions varied between $16.2 and $24.6, $15.8 and $24.3, and $10.1 and $18.6, respectively. CONCLUSION:The cost of surgery in the study setting compares favorably with other prioritized health care interventions, such as treatment for tuberculosis, human immunodeficiency virus/AIDS, and childhood immunization. Surgery in low-income settings can be made more cost effective, leading to increased quantity and improved quality of surgical services.
journal_name
Surgeryjournal_title
Surgeryauthors
Löfgren J,Mulowooza J,Nordin P,Wladis A,Forsberg BCdoi
10.1016/j.surg.2015.01.026subject
Has Abstractpub_date
2015-06-01 00:00:00pages
983-91issue
6eissn
0039-6060issn
1532-7361pii
S0039-6060(15)00141-5journal_volume
157pub_type
杂志文章相关文献
SURGERY文献大全abstract：BACKGROUND:Bacterial translocation has been implicated in the alteration of the immune response after shock and trauma. This study examined the effect of bacterial translocation on myelopoiesis after hemorrhagic shock in germ-free and conventional rats. METHODS:Awake, unrestrained germ-free and conventional rats were ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-10-01 00:00:00
abstract：BACKGROUND:Patients with primary hyperparathyroidism often lack classic symptoms but can have reductions in bone mineral density and increased fracture risk. We sought to determine bone mineral density improvement after successful surgery and associated factors. METHODS:A review of patients with osteopenia or osteopor...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2012.08.015
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:Estimates of the number of firearm-related injuries widely vary. Although focus has been primarily on deaths, the societal cost of caring for victims of these injuries is largely unknown. Our goal was to estimate the economic impact of nonfatal, firearm-related injuries in the United States based on recent, ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2014.02.011
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:Our ability to predict respiratory compromise during general anesthesia in a child with an anterior mediastinal mass is limited. Two prior reports have found a correlation between adequacy of ventilation during general anesthesia and the tracheal cross-sectional area obtained from computed tomograms (compute...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(05)80360-5
更新日期：1995-09-01 00:00:00
abstract：:Metabolic alkalosis secondary to chloride depletion, especially following gastrointestinal surgery and associated with acute renal failure, is a frequent clinical occurrence. Management of the resultant acid-base disturbance mandates chloride replacement. The presence of oliguria limits the choice of accompanying cati...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1975-10-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine performance retention after initial and ongoing Fundamentals of Laparoscopic Surgery (FLS) skills training. METHODS:Surgery residents (postgraduate year [PGY] 1-5; n = 91) initially underwent proficiency-based training during a 2-month period for all 5 FLS tasks. S...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2009.05.009
更新日期：2009-08-01 00:00:00
abstract：:The effectiveness of prosthetic femoropopliteal bypass grafts to salvage limbs and maintain long-term patency in lower extremities with a limited outflow tract is controversial. To evaluate the results of prosthetic grafts and compare them with the results of vein bypass grafts in limbs with a limited outflow tract, w...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1982-04-01 00:00:00
abstract：:We report a case in which a large, postoperative, biliary cutaneous fistula was successfully treated by means of endoscopic insertion of two endoprostheses into the common bile duct. Twenty-four hours after the procedure, bile flow from the cutaneous fistula ceased completely. The endoprostheses were removed after 6 w...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
abstract：BACKGROUND:Despite development of current targeted therapies for medullary thyroid cancer (MTC), long-term survival remains unchanged. Recently isolated novel withanolide compounds from Solanaceae physalis are highly potent against MTCs. We hypothesize that these withanolides uniquely inhibit RET phosphorylation and th...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2012.08.031
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:Although various suture techniques for murine pancreas transplantation have been described, severe limitations have limited their widespread use. We therefore designed a surgical model for cervical heterotopic pancreas transplantation using a cuff technique. METHODS:C57BL6 mice were used as donor and recipi...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2006.07.037
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:The outcomes of operative repair of intestinal-cutaneous fistulas vary widely throughout the literature. We aimed to investigate whether the modified frailty index-5 is a reliable tool to account for physiologic reserve and whether it serves as a predictor of Clavien-Dindo grade IV complications in those wit...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2020.11.018
更新日期：2021-01-04 00:00:00
abstract：:From 1979 to 1990, 33 children required operative treatment for pancreatitis. Causes included ductal abnormalities (12 children), trauma (10 children), idiopathic (four children), gallstones (three children), drug-induced (three children), and tumor (one child). This study reviews the characteristics and outcome of th...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1991-10-01 00:00:00
abstract：:Multivisceral isografts and allografts were transplanted to Lewis rats, and the histopathologic changes were studied in the liver, intestine, and other constituent organs. Rats receiving isografts had indefinite survival with maintenance of weight. With multivisceral allografts (from Brown-Norway donors), the intestin...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1990-11-01 00:00:00
abstract：:Patients with chronic renal failure and total diversion of the lower urinary tract have been considered poor transplant candidates, and post-transplant urinary diversion, i.e., Bricker loop, has been thought to be necessary. Our experience with nine patients clearly indicates that these patients are actually excellent...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：:The viability of the heart from irreversibly shocked dogs was evaluated. Thirty-one mongrel dogs were used to develop a uniformly lethal hemorrhagic shock model. The final model utilized a 30 mm. Hg mean arterial pressure with a 40 percent decompensation (uptake of reservoir blood). All control dogs subjected to this ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1975-01-01 00:00:00
abstract：BACKGROUND:Physical and psychosocial morbidity of multiple endocrine neoplasia type-1 is ill-defined. How disease and treatment-related factors relate to patient-reported outcomes including health-related quality of life is unknown. We hypothesized that disease and treatment burden negatively impacts health-related qua...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2017.07.023
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Common anastomotic complications after pancreatoduodenectomy (PD) are leakage from the pancreaticojejunostomy or hepaticojejunostomy. Leakage from the gastroenteric anastomosis has rarely been described. We evaluated the incidence of gastroenteric leakage after PD and described its presentation, treatment, a...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2014.03.044
更新日期：2014-07-01 00:00:00
abstract：:Axial computerized tomography is a useful tool in the evaluation of either primary or metastatic hepatic neoplasms. An adjunct to this technique is visceral arterial enhanced computerized tomography (AECT). To determine the effectiveness of this modality, bolus intravenous enhanced computerized tomography scans and AE...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
abstract：:The shear stress resistance of cultured human endothelium was investigated on 6 mm polytetrafluoroethylene vascular grafts. Endothelial cell attachment was promoted by precoating the grafts with fibrin glue, which contained human fibronectin and inhibitors of fibrinolysis (aprotinin and tranexam acid). To evaluate the...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1989-04-01 00:00:00
abstract：BACKGROUND:Liver resection (LR) for hilar cholangiocarcinoma (HCA) remains challenging because of the occurrence of unanticipated vascular and longitudinal bile duct invasion. Operative strategies to achieve negative resection margins vary, and the benefit of routine portal vein resection (PVR) is discussed controversi...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.04.032
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND:Late graft failure is still a problem for vascular surgeons. A previous study showed superior patency of arterial grafts compared with venous grafts. In this review we discuss the differences in functional and morphologic modulation of experimental autogenous venous and arterial grafts. RESULTS:In canine ve...
journal_title：Surgery
pub_type： 杂志文章,评审
doi：10.1067/msy.2002.119797
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND:The aim of this study was to clarify whether the types of portal vein (PV) occlusion during hepatectomy affect the long-term outcome in patients with hepatocellular carcinoma (HCC). METHODS:Eighty-six patients who had undergone curative hepatic resection for HCC were divided on the basis of the type of PV o...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.02.008
更新日期：2005-06-01 00:00:00
abstract：:The role of splenectomy in the management of immune thrombocytopenia purpura is well known. Recent improvements in laparoscopic technology have significantly expanded the variety of general surgical procedures amenable to a minimally invasive approach. An initial experience of four cases of immune thrombocytopenic pur...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：BACKGROUND:Conventional parathyroidectomy involves a bilateral neck exploration with the patient under general anesthesia with a thorough search for all parathyroid tissue. The purpose of this study was to assess the efficacy and safety of unilateral neck exploration under local anesthesia in patients with asymptomatic...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2099.101834
更新日期：1999-12-01 00:00:00
abstract：BACKGROUND:This study compares the effects of carbon dioxide pneumoperitoneum versus laparotomy on cellular-mediated immune response in a murine model. METHODS:Sixty-eight female C3H/He mice were sensitized to keyhole limpet hemocyanin (KLH) and to a mouse mammary carcinoma cell line (MC2) before surgery. Animals were...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2000.101152
更新日期：2000-01-01 00:00:00
abstract：:The ability of the lung to decrease blood flow to an atelectatic lobe and to increase flow to normal after reinflation was investigated with a model using left lower lobe atelectasis (LLLA) in the dog. The change in the shunt fraction QS/Qt with continuing LLLA was assumed to represent a change in blood flow to the LL...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1977-07-01 00:00:00
abstract：BACKGROUND:The direct impact of burn injury on liver metabolism was studied in a rat liver perfusion system to remove the influence of systemic factors that modulate liver metabolism. METHODS:Seven animals received a burn injury covering 20% of the total body surface area, and seven were sham burned. The in situ liver...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90358-5
更新日期：1997-03-01 00:00:00
abstract：:We studied the role of hypoproteinemia, induced by a major burn injury, on the edema process in burned and nonburned tissues including the lung in the adult sheep. We used lymph flow (QL) and the lymph-plasma (L/P) protein ratio as indicators of the rate of fluid and protein flux across the microcirculation and into t...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1984-02-01 00:00:00
abstract：BACKGROUND:Survivin is a member of the inhibitor of apoptosis protein family, which inhibits apoptosis and regulates cell division. Survivin is expressed by the majority of human cancers, including pancreatic adenocarcinoma. We have reported that its expression is correlated with shorter survival of pancreatic cancer p...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.05.009
更新日期：2005-08-01 00:00:00
abstract：INTRODUCTION:End-stage renal disease (ESRD) is associated with poor medical outcomes. This study aimed to compare early outcomes of elective and emergency operation for diverticulitis among older adults with and without a diagnosis of ESRD. METHODS:Patients 65 years of age and older with a primary diagnosis of diverti...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2014.03.034
更新日期：2014-08-01 00:00:00
