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Advances in Orthopedics
Volume 2017 (2017), Article ID 5109895, 7 pages
Research Article

Cost-Effectiveness Analysis of Total Hip Arthroplasty Performed by a Canadian Short-Stay Surgical Team in Ecuador

1Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
2Canadian Association of Medical Teams Abroad, Edmonton, AB, Canada
3Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada
4Fundación Tierra Nueva, Quito, Ecuador
5Institute of Health Economics, Edmonton, AB, Canada

Correspondence should be addressed to Saifee Rashiq

Received 25 August 2017; Revised 24 October 2017; Accepted 14 November 2017; Published 18 December 2017

Academic Editor: Allen L. Carl

Copyright © 2017 Michael Schlegelmilch et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Few charitable overseas surgical missions produce cost-effectiveness analyses of their work. Methods. We compared the pre- and postoperative health status for 157 total hip arthroplasty (THA) patients operated on from 2007 to 2011 attended by an annual Canadian orthopedic mission to Ecuador to determine the quality-adjusted life years (QALYs) gained. The costs of each mission are known. The cost per surgery was divided by the average lifetime QALYs gained to estimate an incremental cost-effectiveness ratio (ICER) in Canadian dollars per QALY. Results. The average lifetime QALYs (95% CI) gained were 1.46 (1.4–1.5), 2.5 (2.4–2.6), and 2.9 (2.7–3.1) for unilateral, bilateral, and staged (two THAs in different years) operations, respectively. The ICERs were $4,442 for unilateral, $2,939 for bilateral, and $4392 for staged procedures. Seventy percent of the mission budget was spent on the transport and accommodation of volunteers. Conclusion. THA by a Canadian short-stay surgical team was highly cost-effective, according to criteria from the National Institute for Health and Care Excellence and the World Health Organization. We encourage other international missions to provide similar cost-effectiveness data to enable better comparison between mission types and between mission and nonmission care.