SynthesisBMJ global health2024
Cost-effectiveness of surgical interventions in low-income and middle-income countries: a systematic review and critical analysis of recent evidence.
Synthesis in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Where do delays occur? A systematic review of the barriers to early breast cancer diagnosis across South Africa's health system.BMJ open · 2026Pooled it
- Costs of surgeries in low- and middle-income countries: a systematic literature review.BMJ global health · 2026Pooled it
- Economic value of international missions and domestic initiatives to strengthen surgical care in low- and middle-income countries: systematic review.The British journal of surgery · 2025Pooled it
- Association of surgery and economic development in low- and middle-income countries: evidence from a dynamic panel data analysis.BMJ global health · 2026Article
- Article
- National surgical, obstetrics, and anaesthesia plans in Sub-Saharan Africa: a comparative economic content analysis.BMC health services research · 2026Article
- Preferences for Infection Prevention in Hospital-Acquired Infections.JAMA network open · 2026Article
- Controversies and conundrums in global surgery.The British journal of surgery · 2025Article
- Financing surgery in LMICs: building sustainable and equitable systems for universal surgical access - a narrative review.BMC surgery · 2025Review
- Laminoplasty compared to laminectomy and fusion for degenerative cervical myelopathy: a cost-utility analysis.North American Spine Society journal · 2025Article
- The importance of peer reviewed, PubMed® listed journals in the age of Open Access journal publishing.Journal of hip preservation surgery · 2025Article
- Global burden of emergency and operative conditions: an analysis of Global Burden of Disease data, 2011-2019.Bulletin of the World Health Organization · 2025Article
- Who pays for surgical care in the global south? A narrative review.PLOS global public health · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCost-effectiveness evidence is a critical tool to support resource allocation decisions. There is growing recognition that the development of benefit packages for surgical care should be guided by such evidence, particularly in resource-constraint settings.
methodsWe conducted a systematic review of evidence (Medline, Embase, Global Health, EconLit and grey literature) on the cost-effectiveness of surgery across low-income and middle-income countries published between January 2013 and January 2023. We included studies with minor and major therapeutic surgeries and minimally invasive intraluminal and endovascular interventions. We computed and compared the average cost-effectiveness ratios (ACERs) for different surgical interventions to the respective national gross domestic product per capita to determine cost-effectiveness and to common traditional public health interventions.
resultsWe identified 87 unique studies out of 20 070 articles screened. Studies spanned 23 countries, with China (n=20), Thailand (n=12), Brazil (n=8) and Iran (n=8) accounting for about 55% of the evidence. Overall, the median ACERs across procedure groups ranged from I$17/disability-adjusted life year (DALY) for laparotomies to I$170 186/DALY for bariatric surgeries. Most of the ACER estimates were classified as cost-effective (89%) or very cost-effective (76%). Low-complexity surgical interventions compared favourably to common public health interventions.
conclusionThese findings reinforce the growing body of evidence that investments in surgery are economically smart. There remains however paucity of high-quality evidence that would allow decision-makers to assess the comparative cost-effectiveness of surgery and to determine best buys across a wide range of specialties and interventions. A concerted effort is needed to advance the generation and utilisation of economic evidence in the drive towards scale-up of surgical care across low-income and middle-income countries.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.