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 language | English (US) |
|---|---|
| Article number | 90 |
| Journal | BMC Medicine |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| State | Published - Apr 22 2015 |
| Externally published | Yes |
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Keywords
- Complex wound
- Cost-benefit analysis
- Cost-effectiveness analysis
- Research design
- Skin ulcer
- Systematic review
ASJC Scopus subject areas
- Medicine(all)
Cite this
A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types. / Tricco, Andrea C.; Cogo, Elise; Isaranuwatchai, Wanrudee; Khan, Paul A.; Sanmugalingham, Geetha; Antony, Jesmin; Hoch, Jeffrey S; Straus, Sharon E.
In: BMC Medicine, Vol. 13, No. 1, 90, 22.04.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types
AU - Tricco, Andrea C.
AU - Cogo, Elise
AU - Isaranuwatchai, Wanrudee
AU - Khan, Paul A.
AU - Sanmugalingham, Geetha
AU - Antony, Jesmin
AU - Hoch, Jeffrey S
AU - Straus, Sharon E.
PY - 2015/4/22
Y1 - 2015/4/22
N2 - 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.
AB - 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.
KW - Complex wound
KW - Cost-benefit analysis
KW - Cost-effectiveness analysis
KW - Research design
KW - Skin ulcer
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=84928167934&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928167934&partnerID=8YFLogxK
U2 - 10.1186/s12916-015-0326-3
DO - 10.1186/s12916-015-0326-3
M3 - Article
C2 - 25899057
AN - SCOPUS:84928167934
VL - 13
JO - BMC Medicine
JF - BMC Medicine
SN - 1741-7015
IS - 1
M1 - 90
ER -