Show simple item record

dc.contributor.authorShrime, Mark G.en_US
dc.contributor.authorSleemi, Ambereenen_US
dc.contributor.authorRavilla, Thulasiraj D.en_US
dc.date.accessioned2015-01-05T18:27:03Z
dc.date.issued2014en_US
dc.identifier.citationShrime, Mark G., Ambereen Sleemi, and Thulasiraj D. Ravilla. 2014. “Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost-Effectiveness, Sustainability, and Role Training.” World Journal of Surgery 39 (1): 10-20. doi:10.1007/s00268-014-2516-0. http://dx.doi.org/10.1007/s00268-014-2516-0.en
dc.identifier.issn0364-2313en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:13581107
dc.description.abstractObjective: This study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed. Methods: A systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included. Results: Surgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited. Conclusions: Because the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.en
dc.language.isoen_USen
dc.publisherSpringer USen
dc.relation.isversionofdoi:10.1007/s00268-014-2516-0en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179995/pdf/en
dash.licenseLAAen_US
dc.titleCharitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost-Effectiveness, Sustainability, and Role Trainingen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalWorld Journal of Surgeryen
dash.depositing.authorShrime, Mark G.en_US
dc.date.available2015-01-05T18:27:03Z
dc.identifier.doi10.1007/s00268-014-2516-0*
dash.contributor.affiliatedShrime, Mark


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record