New research suggests that elective hernia surgery offers value-for-money and improved quality of life for patients.
The new analysis is based on patients’ own assessments of their health-related quality of life together with costs reported by hospitals. The research also indicates that keyhole surgery may offer more health benefit and value for money than open surgery for hernia operations. Recently it has been suggested that the NHS could save money by reducing access to hernia repair surgery.
Since 2009, hospitals carrying out NHS-funded surgery on hernias, varicose veins, hip and knee replacements have been required to collect data from patients assessing their own health-related quality of life using questionnaires before and after their operations. These assessments, known as patient-reported outcome measures (PROMs), are designed to enable comparisons of the health benefits resulting from different treatments.
Researchers from Imperial College London and The King’s Fund used PROMs data to estimate the cost-effectiveness of open surgery and keyhole surgery for hernia repair. The results are expressed as a cost per quality-adjusted life year (QALY), a widely-used standard measure of treatment benefit.
The results show that hernia surgery appears cost-effective, with an average cost per QALY of £1,881. They also show that patients report greater health benefit after keyhole surgery than open surgery. The National Institute for Health and Clinical Excellence (NICE) normally recommends treatments costing up to £20,000 to £30,000 per QALY.
Sophie Coronini-Cronberg, from the School of Public Health at Imperial College London, who led the study, said: “Our results challenge the idea that hernia surgery has low clinical value. Based on what patients tell us about how the treatments help them, it would seem that hernia surgery not only improves people’s lives substantially but also represents good value for NHS spending.”
The research was published by the Journal of the Royal Society of Medicine.
