This group is then means-tested by the Social Work Department of FTN according to its own criteria in order to confirm that they could not otherwise afford the cost of surgery and is then referred to CAMTA. FTN considers household size, total household income, and the number of children or others depending on the earning potential of the patient in order to determine eligibility for CAMTA services, seeking always to prioritize those in the greatest need.
Upon CAMTA's arrival, prospective candidates are screened for surgical appropriateness by Canadian surgeons.
They were asked to return for follow-up with CAMTA one year later.
CAMTA began administering the 15D to patients at follow-up in 2012, for patients that received surgery in 2011 and so, in order to group patient data from all five mission years (2007-2011), we cross-walked the SF-36 from each patient onto the 15D.
Costs are from the perspective of CAMTA and all of CAMTA's expenditures are precisely recorded to comply with its registered charity status.
The data were stored in sealed boxes to which only senior CAMTA staff had access.
During the five-year study, CAMTA operated on 157 adult patients receiving THA.
If CAMTA had paid the full cost of prostheses, the ICER would have risen by $1,072.67 (24%) for unilateral THA, by $1,496.86 (51%) for bilateral surgery, and by $1,104.39 (25%) for staged surgery.
This suggests that, by these definitions, bilateral THAs performed by CAMTA were highly cost-effective.
This is a limitation of our study, as we could not account for costs of complications or revisions that CAMTA did not manage.
It is prudent to acknowledge that the perspective of analysis is from that of CAMTA and does not account for costs to patients or to the Ecuadorian health system or the opportunity costs of people and space used for this mission to operate.