Background/Purpose: Technological developments have revolutionized both dia
gnosis and treatment in neonatal surgery. However, it has been increasingly
recognized that financial resources might become insufficient to provide a
ll the medical care that is technically feasible or that patients and famil
ies might desire. The purpose of this study is to apply the theory of healt
h economics to neonatal surgery and to explore the extent and the kind of e
conomic evaluation done in neonatal surgery.
Methods: To explore the work done so far, the authors undertook a literatur
e search aimed at costs and effects of surgical interventions in newborns w
ith Ravitch' surgical index diagnoses of congenital anomalies. Common keywo
rds in cost-effectiveness analysis were used to search Medline.
Results: Evidence about the cost effectiveness of neonatal surgery is large
ly lacking. This is probably because of difficulties in long-term tracking
of the patients and to the problem that most generic quality-of-life measur
es are not applicable in children yet.
Conclusions: Further cost-effectiveness research in neonatal surgery is war
ranted to settle priority discussions in health care when neonatal surgery
is part of such discussions. Methodology for generic quality-of-life measur
ement in children is badly needed. Copyright (C) 2000 by W.B. Saunders Comp
any.