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Peri-operative pulse oximetry in low-income countries : a cost–effectiveness analysis
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Burn, Samantha L., Chilton, Peter J., Gawande, Atul A. and Lilford, Richard (2014) Peri-operative pulse oximetry in low-income countries : a cost–effectiveness analysis. Bulletin of the World Health Organization, Volume 92 (Number 12). pp. 858-867. doi:10.2471/BLT.14.137315 ISSN 0042-9686.
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Official URL: http://dx.doi.org/10.2471/BLT.14.137315
Abstract
he pulse oximeter is a non-invasive medical device that monitors oxygen saturation and pulsation. When used continuously during surgery, it can provide early warning of hypoxia, hypovolaemia and impending cardiac arrest. Since oximetry can warn of problems such as misplaced endotracheal tubes – which can readily be rectified – the World Federation of Societies of Anaesthesiologists recommends its routine use for every patient undergoing anaesthesia in the world.1,2 The World Health Organization (WHO) includes pulse oximetry as a component of its Surgical Safety Checklist, which is recommended for use in every operating theatre.1 However, it has recently been estimated that pulse oximetry is unavailable in 51–70% of operating theatres in low-income countries,3 partly because of the high purchase cost of a standard commercial tabletop pulse oximeter – approximately 1000 United States dollars (US$).4 The Lifebox oximetry project, which currently operates alongside the WHO Safe Surgery Saves Lives initiative, provides a hand-held pulse oximeter for low- and middle-income countries that costs US$ 250.4 However, even this smaller sum is a considerable investment for resource-constrained settings. Furthermore, because no evidence of the cost–effectiveness of pulse oximetry for peri-operative monitoring in low-income countries has yet been published, it is not clear how oximetry should be prioritized among the many cost–effective interventions available.5 In this paper, we conducted a cost–effectiveness analysis of pulse oximetry – compared with no peri-operative monitoring – for patients undergoing surgery in low-income countries. This study is based on a synthesis of data from previously published studies from a large number of different countries. While the group of low-income countries is heterogeneous, the analysis presented here is readily adaptable to specific national contexts.
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Bulletin of the World Health Organization | ||||||||
Publisher: | World Health Organisation | ||||||||
ISSN: | 0042-9686 | ||||||||
Official Date: | December 2014 | ||||||||
Dates: |
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Volume: | Volume 92 | ||||||||
Number: | Number 12 | ||||||||
Page Range: | pp. 858-867 | ||||||||
DOI: | 10.2471/BLT.14.137315 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) |
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