Meaume S, Gemmen E
Department of Geriatrics, Groupe Hospitalier Charles Foix, Ivry-sur-Seine, France.
J Wound Care. 2002 Jun;11(6):219-24. doi: 10.12968/jowc.2002.11.6.26408.
This study set out to define realistic protocols of care for the treatment of chronic venous leg ulcers and pressure ulcers in France and, by developing cost-effectiveness models, to compare the different protocols of care for the two ulcer groups, enabling a calculation of direct medical costs per ulcer healed in a typical French health insurance plan.
Clinical outcomes and some treatment patterns were obtained from published literature. Validations of different treatment patterns were developed using an expert consensus panel similar to the Delphi approach. Costs were calculated based on national averages and estimates from the UK and Germany. The models were used to measure costs per healed ulcer over a 12-week period.
For both the pressure ulcer and venous leg ulcer models, three protocols of care were identified. For pressure ulcers and venous leg ulcers, the hydrocolloid DuoDERM (ConvaTec, also known as Granuflex in the UK and Varihesive in Germany) was most cost-effective in France.
The combination of published data and expert consensus opinion is a valid technique, and in this case suggests that treating pressure ulcers and venous leg ulcers with hydrocolloid dressings is more cost-effective than treating them with saline gauze, in spite of the lower unit cost of the latter.
本研究旨在确定法国慢性腿部静脉溃疡和压疮治疗的切实可行的护理方案，并通过建立成本效益模型，比较这两类溃疡的不同护理方案，从而能够计算出法国典型医疗保险计划中每治愈一例溃疡的直接医疗成本。
临床结果和一些治疗模式来自已发表的文献。使用类似于德尔菲法的专家共识小组对不同治疗模式进行验证。成本根据全国平均水平以及英国和德国的估计数计算。这些模型用于衡量12周内每治愈一例溃疡的成本。
在压疮和腿部静脉溃疡模型中，均确定了三种护理方案。在法国，对于压疮和腿部静脉溃疡，水胶体敷料多爱肤（康维德公司，在英国也称为优格托，在德国称为爱立舒）最具成本效益。
已发表数据与专家共识意见相结合是一种有效的技术，在本案例中表明，用水胶体敷料治疗压疮和腿部静脉溃疡比用盐水纱布治疗更具成本效益，尽管后者的单位成本较低。
