While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .
Outpatient haemorrhoidectomy under local anaesthesia.
OBJECTIVE To compare early and late results and costs of  outpatient haemorrhoidectomy under local anaesthesia  with those of  inpatient haemorrhoidectomy .  DESIGN Prospect i ve study with historical controls . SETTING University hospital , Brazil . SUBJECTS 51 patients who required haemorrhoidectomy . INTERVENTIONS Outpatient haemorrhoidectomy under local anaesthesia . MAIN OUTCOME MEASURES Early and late results and comparative costs . RESULTS One patient was withdrawn from the study because of hypertension and subsequently lost to follow-up . The remaining 50 patients were discharged a mean of 68 ( 23 ) minutes after operation . Twelve patients complained of severe pain , one had faecal impaction and 2 developed bleeding . One patient developed urinary retention , compared with 18 in the historical group ( p < 0.001 ) . Forty-two patients ( 84 % ) were thoroughly satisfied with their treatment . Late complications did not differ significantly from those observed in the historical group . The estimated hospital costs were US$ 313.6 for outpatient , and US$ 716 for inpatient treatment . CONCLUSION Outpatient haemorrhoidectomy under local anaesthesia was safe and comfortable for most patients , with complication rates comparable to or better than those observed after inpatient treatment and at less than half the cost
While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .