title: Cost Per DALY Averted in a Surgical Unit of a Private Hospital in India.
abstract: BACKGROUND
  Cost-effectiveness analysis plays an important role to guide resource allocation decisions, however, information on cost per disability-adjusted life year (DALY) averted by health facilities is not available in many developing economies, including India. We estimated cost per DALY averted for 2611 patients admitted for surgical interventions in a 106-bed private for-profit hospital in northern India.
  
  
  METHODS
  Costs were calculated using standard costing methods for the financial year 2012-2013, and effectiveness was measured in DALYs averted using risk of death/disability, effectiveness of treatment and disability weights from 2010 global burden of disease study.
  
  
  RESULTS
  During the study period, total operating cost of the hospital for treating surgical patients was USD 1,554,406 and the hospital averted 9401 DALYs resulting in a cost per DALY averted of USD 165.
  
  
  CONCLUSIONS
  Even though this study was based on one hospital in India, however, the hospital is a private hospital which is expected to have less surgical case load compared to government health facilities, cost per DALY averted for the surgical interventions is much lower than the cost-effectiveness threshold for India (USD 1508 in 2012). This study therefore provides evidence to re-think the common notion that surgical care is expensive and therefore of lower value than other health interventions.
authors.affiliation: Public Health Foundation of India, Plot No. 47, Sector 44, Gurgaon, New Delhi, 122002, India. susmita.c@phfi.org.
authors.forename: Susmita
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Public Health Foundation of India, Plot No. 47, Sector 44, Gurgaon, New Delhi, 122002, India.|Center for Disease Dynamics, Economics & Policy, Washington, DC, USA.|Princeton Environmental Institute, Princeton University, Princeton, NJ, USA.
authors.forename: Ramanan
authors.initials: R
authors.lastname: Laxminarayan
authors.affiliation: Department of Orthopedic Surgery, Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, CA, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Gosselin
mesh_terms: D003362:Cost-Benefit Analysis; D017721:Hospital Costs; D006757:Hospital Units / Q000191:economics; D006760:Hospitalization / Q000191:economics; D016304:Hospitals, Private / Q000191:economics; D006801:Humans; D007194:India; D019057:Quality-Adjusted Life Years; D013514:Surgical Procedures, Operative / Q000191:economics* / Q000706:statistics & numerical data