Global Burden of Pediatric Surgical Disease

The recognition of surgical care as an essential component of health care has required evidence of its potential impact in health care systems and cost-effectiveness by comparison with other standard interventions. Such evidence, essential for advocacy for resource allocation in LMICs, is very limited in children. Not only are there few outcomes and cost-effectiveness studies in the specialty, but the required disability weights for most common pediatric surgical conditions are missing, and multidisciplinary long-term follow-up is virtually non-existing, even in high-resource countries.
The focus of this thesis is therefore two-fold. In part I the theoretical framework for surgical burden of disease measurement is reviewed and critiqued, with several alternative metrics usable in pediatric surgery being offered.
Part II includes several empirical studies exploring the implications and applications of the theoretical framework. This includes generating disability weights within pediatric surgery, then establishing the evidence for the burden of surgical disease in children and the cost-effectiveness of its treatment.