Global economic consequences of selected surgical diseases: a modelling study

Abstract

Background The surgical burden of disease is substantial, but little is known about the associated economic consequences. We estimate the global macroeconomic impact of the surgical burden of disease due to injury, neoplasm, digestive diseases, and maternal and neonatal disorders from two distinct economic perspectives. Methods The value of lost output (VLO) approach projects annual market economy losses during 2015-2030 by relating disease mortality to changes in the labor force and gross domestic product (GDP). The value of lost welfare (VLW) approach uses a broader measure of nonmarket losses based on a concept termed the value of a statistical life and estimates the present value of long-run welfare losses resulting from mortality and short-run welfare losses resulting from morbidity incurred during 2010. Sensitivity analyses are performed for both approaches. Findings During 2015-2030, the VLO approach projects surgical conditions to result in losses of 1·25%of potential GDP, or $20·7 trillion (2010 USD, PPP). When expressed as a proportion of potential GDP, annual GDP losses are greatest in low- and middle-income countries, with up to a 2·5% loss in output by 2030. When nonmarket losses are assessed (VLW), the present value of economic welfare losses is estimated to be equivalent to 17% of 2010 GDP, or $14.5 trillion (2010 USD, PPP). Neoplasm and injury account for greater than 95% of total economic losses in each approach, but maternal, digestive, and neonatal disorders, which represent only 4% of losses in high-income countries in the VLW approach, contribute to 26% of losses in low-income countries. Interpretation The macroeconomic impact of surgical disease is substantial and inequitably distributed. When paired with the growing number of favorable cost-effectiveness analyses of surgical interventions in low- and middle-income countries, our results suggest that building surgical capacity should be a global health priority.