Economic Valuation of the Global Burden of Cleft Disease Averted by a Large Cleft Charity

Poenaru, Dan; Lin, Dan; Corlew, Scott

doi:10.1007/s00268-015-3367-z

Cited by 42 publications

(41 citation statements)

References 42 publications

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“…The centre of Operation Smile reports a short-term complication rate of 4.0% (cleft lip repair) and 15.8% (cleft palate repair), which is lower than the rates of their counterpart short-term missions 39. Smile Train studies report lower rates, between 0.88% and 3% 70 71 73 78. However, they note that there might be a risk of under-reporting or selection bias due to a dependence of Smile Train surgeons on payment-per-patient (risking fewer referrals when higher complication rates are reported) and a limited capacity of surgeons to treat complex cases 70 71 73 78.…”

Section: Discussionmentioning

confidence: 98%

“…Specialty hospitals provide continuous care all year round in a LMIC. The cleft care centre of Operation Smile in India,39 or Smile Train’s model are examples of this approach 69–78…”

Section: Discussionmentioning

confidence: 99%

“…Smile Train studies report lower rates, between 0.88% and 3% 70 71 73 78. However, they note that there might be a risk of under-reporting or selection bias due to a dependence of Smile Train surgeons on payment-per-patient (risking fewer referrals when higher complication rates are reported) and a limited capacity of surgeons to treat complex cases 70 71 73 78. Furthermore, with only one Smile Train study reporting on follow-up lengths,73 these complication rates should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

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Impact of short-term reconstructive surgical missions: a systematic review

et al. 2019

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IntroductionShort-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries.MethodsA systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates.ResultsOf 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months’ follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics.ConclusionsEvidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems.PROSPERO registration numberCRD42018099285.

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Section: Discussionmentioning

confidence: 98%

“…Specialty hospitals provide continuous care all year round in a LMIC. The cleft care centre of Operation Smile in India,39 or Smile Train’s model are examples of this approach 69–78…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of short-term reconstructive surgical missions: a systematic review

et al. 2019

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“…This is accomplished through long-term financial commitments and by providing training to local surgeons, with the goal of ultimately making foundational support obsolete. The horizontal model has been effective in many LMICs, with substantial disability-adjusted life years (DALYs) averted in a cost-effective manner [18,19]. However, the success of this model hinges on extended periods of investment from charitable organizations, as well as from individual providers, and this limits the scope of this strategy.…”

Section: Models Of Cleft Care Deliverymentioning

confidence: 99%

Optimizing Outcomes in Cleft Surgery

Park¹,

Deshpande²,

Schönmeyr³

et al. 2020

Current Treatment of Cleft Lip and Palate

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Children born with cleft lip and palate in low-and middle-income countries (LMICs) have limited access to surgical care and suffer substantial morbidity as a result of delayed treatment. Charitable organizations have sought to tackle this problem through high-volume surgical missions, but these efforts have been fraught with high rates of complications and variable esthetic results. Over the past decade, Operation Smile (OS) has placed considerable emphasis on improving the quality of care delivered to patients in LMICs. By establishing an outcome evaluation program among other interventions, OS has achieved measurable improvements in complication rates and post-operative follow-up. The founding of the Guwahati Comprehensive Cleft Care Center in India has been pivotal to the success of OS's work in this field and is the evidence of the impact that an optimized model of care delivery can make. Here we describe OS's efforts to improve the quality of care delivered to patients in LMICs with a focus on the organization's work in India.Keywords: cleft lip and palate, low and middle-income countries, global surgery, models of health care delivery, quality improvement Current Treatment of Cleft Lip and Palate

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“…The average economic value of the services provided was estimated to range from USD 5510 to 50,634 per individual. [15] India is among those countries with high rates of untreated CL/P cases. In many parts of India, there is no access to information, counseling, or treatment.…”

Section: Introductionmentioning

confidence: 99%

Team Care Protocols for Individuals with Cleft Lip and Palate and Modified Protocols for Developing Countries

Oberoi

Sinha

Devgon

et al. 2018

J Indian Orthod Soc

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Team care is essential to meet the medical, surgical, dental, orthodontic, and psychological needs of individuals with cleft lip and palate. The currently accepted standards of care can only be met if the appropriate specialists work together in the diagnosis and treatment planning, both immediate and long term and in the execution of the various treatments needed. Interdisciplinary team care provides the best overall outcomes for the individual and is also the most efficacious and cost-effective way of meeting the goals of treatment. Interdisciplinary cleft team members should also be a resource in educating parents, students, and other healthcare providers and may participate in research in prevention, interception, and regeneration. We present here the orthodontic protocols of the cleft and craniofacial team at the University of California at San Francisco and provide guidelines for the most essential treatment.

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Economic Valuation of the Global Burden of Cleft Disease Averted by a Large Cleft Charity

Cited by 42 publications

References 42 publications

Impact of short-term reconstructive surgical missions: a systematic review

Impact of short-term reconstructive surgical missions: a systematic review

Optimizing Outcomes in Cleft Surgery

Team Care Protocols for Individuals with Cleft Lip and Palate and Modified Protocols for Developing Countries

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