Comparing the Cost-Effectiveness of Short Orthopedic Missions in Elective and Relief Situations in Developing Countries

The earthquake that occurred in Haiti on 12 January 2010 elicited an unprecedented response from the American orthopedic community. Many small organizations, such as Operation Rainbow, were thrust into the unfamiliar environment of relief surgery, whereas they normally provide short elective reconstruction missions in developing countries. Because of the chaotic nature of relief work, it was assumed that the organization's efforts would be less cost-effective than their usual elective work. To evaluate this conclusion, the present study was designed to compare the cost-effectiveness of the organization's usual elective missions with the emergency relief provided in the wake of the Haiti earthquake. The assumption that emergency costs would be higher was proven wrong, with estimates of $362 per disability-adjusted life-year (DALY) averted in the elective group, and $343 per DALY averted in the relief group.