Cost-effectiveness of screening for developmental dysplasia of the hip in Karachi, Pakistan using a universally applicable cost-effectiveness model

Manon Pigeolet, Hesham Gaafar, Dana Naamani, Mansoor Ali Khan, Blake Christian Alkire, Muhammad Amin Chinoy, Daniel Scott Corlew and Eduardo Novais

ULB Institutional Repository from ULB -- Universite Libre de Bruxelles

Abstract: Introduction Developmental dysplasia of the hip (DDH) is a congenital anomaly of the hip socket that can lead to lifelong disability and pain when left untreated. DDH is a good candidate for screening because of its high frequency in population, availability of treatment and the possibility of secondary prevention. Pakistan currently does not have any systematic or universal neonatal screening programme for DDH. Methods The cost-effectiveness model in this study uses one decision tree for each screening scenario: (1) the status quo, (2) universal screening by clinical examination, (3) universal screening by clinical examination with targeted ultrasound (US) screening, (4) and universal screening by US. Loss of disability-adjusted life-years (DALYs) is used as outcome variable. Results When left untreated DDH creates a loss of 3.4 DALYs per person. Clinical examination and targeted US averts most DALYs per dollar spent. Generalised US averts more DALYs overall but requires a greater financial investment per DALY averted. Conclusions Universal US screening reaches more children and can be considered the more equitable approach but requires 10 times the financial investment clinical examination and targeted US requires. The decision which option is most appropriate for Karachi, Pakistan depends on resource availability, geography, infrastructure, treatment capacity, health system values and societal factors in Pakistan.

Date: 2024-07-01
References: View complete reference list from CitEc
Citations:

Published in: BMJ Public Health (2024) v.2 n° 1,p.e000340

Downloads: (external link)
https://dipot.ulb.ac.be/dspace/bitstream/2013/387005/3/e000340.full.pdf Œuvre complète ou partie de l'œuvre (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:ulb:ulbeco:2013/387005

Ordering information: This working paper can be ordered from
http://hdl.handle.ne ... lb.ac.be:2013/387005

Access Statistics for this paper

More papers in ULB Institutional Repository from ULB -- Universite Libre de Bruxelles Contact information at EDIRC.
Bibliographic data for series maintained by Benoit Pauwels ().