Economic Modelling Approaches for Evaluating Interventions That Reduce Surgery Waiting Times

Speaker(s)

Hren R1, Abaza N2, Elezbawy B3, Khalifa AY4, Fasseeh A5, Al Gasseer N6, Kalo Z7
11) Syreon Research Institiute, Budapest, Hungary, 2) Institute of Mathematics, Physics, and Mechanics, Ljubljana, Slovenia, 3)Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia, 2Syreon Middle East, Alexandria, Alexandria, Egypt, 31) Semmelweis University, Hungary; 2) Syreon Middle East, Alexandria, ALX, Egypt, 4World Health Organization Egypt, Cairo, Egypt, 51-Syreon Middle East, Alexandria, Egypt, 2-Faculty of Pharmacy, Alexandria University, Egypt, Alexandria, Alexandria, Egypt, 6WHO Representative Office in Egypt, Cairo, Egypt, 71) Semmelweis University; 2) Syreon Research Institute, Budapest, Hungary

Presentation Documents

OBJECTIVES: Increasing surgery waiting lists pose a significant challenge for healthcare systems worldwide. Various economic models were applied in different settings to compare interventions aimed at reducing waiting lists, specifically comparing immediate surgery with waiting list placement. This study explored modelling approaches, which allowed researchers to assess the cost-effectiveness of reducing waiting times in elective surgeries.

METHODS: On March 12, 2024, we conducted a systematic literature review in MEDLINE/PubMed and Embase/Scopus electronic databases. Eligibility criteria included elective surgeries and economic evaluations of interventions that reduce waiting times. Given the anticipated heterogeneity of the studies, we performed a narrative synthesis for each study and a thematic analysis to present the various modeling techniques used in different contexts.

RESULTS: Nine articles met the inclusion criteria, covering elective surgery procedures in the musculoskeletal system (4 articles), cardiovascular system (2 articles), ophthalmic system (1 article), and gastrointestinal tract (2 articles). The thematic analysis revealed that the most frequently used economic model across various settings was the Markov cohort model, often with long-term time horizons. Deterministic sensitivity analysis was the most commonly performed type of sensitivity analysis. The most employed value drivers in these models were maintenance costs, improvements in quality of life during reduced waiting times, and mortality due to waiting.

CONCLUSIONS: The evidence from this systematic review suggests that reducing waiting times in elective surgery is highly cost-effective and often cost saving. While it may be argued that accounting for specific elective surgeries and specific countries limits the generalizability of the findings, our methodological framework for this study can be readily adapted to analyze the impact of reducing waiting times in different settings.

Code

EE654

Topic

Economic Evaluation, Patient-Centered Research, Study Approaches

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis, Literature Review & Synthesis, Patient-reported Outcomes & Quality of Life Outcomes

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), Gastrointestinal Disorders, Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Sensory System Disorders (Ear, Eye, Dental, Skin), Surgery