A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types

BMC Medicine

Sharon E Straus³  Jeffrey S Hoch¹  Jesmin Antony⁴  Geetha Sanmugalingham⁴  Paul A Khan⁴  Wanrudee Isaranuwatchai¹  Elise Cogo⁴  Andrea C Tricco² 

[1] Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto M5T 3M7, ON, Canada;Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto M5T 3M7, ON, Canada;Department of Geriatric Medicine, University of Toronto, 200 Elizabeth Street, Suite RFE 3-805, Toronto M5G 2C4, ON, Canada;Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto M5B 1W8, ON, Canada

关键词: Systematic review;    Skin ulcer;    Research design;    Cost-effectiveness analysis;    Cost-benefit analysis;    Complex wound;   

Others  :  1174832
DOI  :  10.1186/s12916-015-0326-3

 received in 2014-10-16, accepted in 2015-03-13,  发布年份 2015

【 摘 要 】

Background

Complex wounds present a substantial economic burden on healthcare systems, costing billions of dollars annually in North America alone. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound care management remains unclear. This article summarizes the cost-effectiveness of interventions for complex wound care through a systematic review of the evidence base.

Methods

We searched multiple databases (MEDLINE, EMBASE, Cochrane Library) for cost-effectiveness studies that examined adults treated for complex wounds. Two reviewers independently screened the literature, abstracted data from full-text articles, and assessed methodological quality using the Drummond 10-item methodological quality tool. Incremental cost-effectiveness ratios were reported, or, if not reported, calculated and converted to United States Dollars for the year 2013.

Results

Overall, 59 cost-effectiveness analyses were included; 71% (42 out of 59) of the included studies scored 8 or more points on the Drummond 10-item checklist tool. Based on these, 22 interventions were found to be more effective and less costly (i.e., dominant) compared to the study comparators: 9 for diabetic ulcers, 8 for venous ulcers, 3 for pressure ulcers, 1 for mixed venous and venous/arterial ulcers, and 1 for mixed complex wound types.

Conclusions

Our results can be used by decision-makers in maximizing the deployment of clinically effective and resource efficient wound care interventions. Our analysis also highlights specific treatments that are not cost-effective, thereby indicating areas of resource savings.

Please see related article: http://dx.doi.org/10.1186/s12916-015-0288-5 webcite

【 授权许可】

   
2015 Tricco et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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