COST-SAVING STRATEGIES FOR SUSTAINABLE SURGICAL CARE: A SCOPING REVIEW OF EFFICIENCY MODELS AND POTENTIAL APPROACHES dr.alayande@gmail.com

PW07-02

COST-SAVING STRATEGIES FOR SUSTAINABLE SURGICAL CARE: A SCOPING REVIEW OF EFFICIENCY MODELS AND POTENTIAL APPROACHES

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Rwanda

Oral only

The financial requirements for implementing national surgical healthcare plans range from US$62 million in Namibia to US$17 billion in Nigeria. Despite representing a small portion of overall health sector budgets, surgical plans are often underfunded and poorly executed. As multilateral aid, philanthropy, and innovative domestic financing continue to support surgical systems, there is need to emphasize cost-saving strategies that improve efficiency without compromising quality. This study aimed to identify practical models for reducing surgical healthcare system costs for Low- and Middle-Income Countries through efficiency-driven approaches.

A rapid scoping review was conducted across EMBASE, PubMed, and WHO databases, yielding 310 studies. An additional three case studies from Ministries of Health in Ecuador, Rwanda, and Sierra Leone were purposively included. Following screening by two independent reviewers, 63 studies were retained. Data were analyzed using a theoretical framework developed through a modified Jabareen’s 8-step approach, adapted from Procter’s cost optimization model and the Triple Aim Framework.

Identified cost-saving strategies included preventive surgical health programs (15%), standardized care pathways and guidelines(59%), reforms in healthcare payment models(40%), operational efficiency through lean methods(62%), and adoption of appropriate technologies(22%). Several strategies demonstrated potential for adaptation and scalability in low- and middle-income settings. 29% were from orthopedic surgery and retrospective observational(27%) or economic analysis and modeling studies(20%) at national/state/ministry of health levels(50%). We present specific efficiency measures.

Efficiency models offer a compelling value proposition for governments and ministries by reducing costs while maintaining quality. Prioritizing scalable, evidence-informed strategies is essential for the sustainable implementation of national surgical plans