Orthopaedic Trauma in Low-resource Settings: Measuring Value

Area of Science:

• Orthopedic Surgery
• Health Economics
• Global Health

Background:

• Trauma care's impact in low- and middle-income countries (LMICs) is recognized, but specific economic data for musculoskeletal trauma are lacking.
• Economic evaluations are crucial for resource allocation and demonstrating the value of interventions in LMICs.

Purpose of the Study:

• To review economic analysis methods applicable to low-resource settings for musculoskeletal trauma.
• To synthesize existing cost studies on orthopedic trauma care in LMICs.
• To identify research gaps and advocate for rigorous economic evaluations.

Main Methods:

• Review of economic analysis methodologies (microcosting, societal perspective).
• Systematic review of cost studies related to orthopedic trauma in LMICs.
• Analysis of cost-effectiveness metrics (disability-adjusted life years, quality-adjusted life years).

Main Results:

• Microcosting and a societal perspective are recommended for LMICs due to data limitations.
• Intramedullary nailing for femoral shaft fractures shows strong economic justification.
• Trauma care hospitals and educational initiatives are highly cost-effective.
• Limited economic data exist for other orthopedic trauma interventions.

Conclusions:

• More rigorous economic analyses are needed to establish the value of musculoskeletal trauma care in LMICs.
• Orthopedic surgeons should engage with economic evaluation methodologies.
• Evidence supports specific interventions like intramedullary nailing and broader initiatives like trauma centers.