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

Andrea C. Tricco, Elise Cogo, Wanrudee Isaranuwatchai, Paul A. Khan, Geetha Sanmugalingham, Jesmin Antony, Jeffrey S Hoch, Sharon E. Straus

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number90
JournalBMC Medicine
Volume13
Issue number1
DOIs
StatePublished - Apr 22 2015
Externally publishedYes

Keywords

  • Complex wound
  • Cost-benefit analysis
  • Cost-effectiveness analysis
  • Research design
  • Skin ulcer
  • Systematic review

ASJC Scopus subject areas

  • Medicine(all)

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