RESUMO
BACKGROUND: In Malawi the orthopaedic clinical officer (OCO) training programme trains non-physician clinicians in musculoskeletal care. We studied the cost-effectiveness of this program. METHODS: Hospital logbooks were reviewed for data pertaining to activity in seven district hospitals over a 6-month period. The total costs were divided by the total effectiveness, calculated as disability adjusted life years (DALYs) averted. RESULTS: The total cost-effectiveness of providing orthopaedic care through the OCO training programme was US$92.06 per DALY averted. The mean per hospital was US$138.75 (95% CI: US$69.58-207.91) per DALY averted which is very cost-effective when compared with other health interventions. Of the 837 patients treated 63% were aged <15 years and 36% were in the 'economically active' demographic of ages 15-74 years. CONCLUSION: Training of clinical officers in orthopaedic surgery is very cost-effective and allows transfer of skills into rural areas. The demographics suggest that failure to provide such care would have a negative economic impact.
Assuntos
Procedimentos Ortopédicos/economia , Ortopedia/economia , Adolescente , Adulto , Idoso , Pessoal Técnico de Saúde/economia , Pessoal Técnico de Saúde/educação , Criança , Pré-Escolar , Análise Custo-Benefício , Atenção à Saúde/economia , Educação Médica/economia , Feminino , Custos Hospitalares/estatística & dados numéricos , Humanos , Lactente , Malaui , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/estatística & dados numéricos , Ortopedia/educação , Ortopedia/estatística & dados numéricos , Anos de Vida Ajustados por Qualidade de Vida , Adulto JovemRESUMO
After a physician volunteers in the developing world, his or her eyes open to vast problems. There are many opportunities for physicians to volunteer in developing countries. Medical personnel should know the major agencies that send volunteers and understand how their actions help in disaster relief, direct patient care, or teaching. Volunteers should work with major established organizations to ensure they are not more of a burden than a help. Individuals assisting in training, development, or human rights investigations can change the world by their efforts.
