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使用持续释放银的泡沫敷料治疗延迟愈合的腿部溃疡可实现具有成本效益的更快伤口愈合——一项卫生经济学分析。

Cost-effective faster wound healing with a sustained silver-releasing foam dressing in delayed healing leg ulcers--a health-economic analysis.

作者信息

Scanlon Elizabeth, Karlsmark Tonny, Leaper David J, Carter Kate, Poulsen Peter B, Hart-Hansen Kristian, Hahn Tina W

机构信息

Leeds Teaching Hospitals Trust, St James University Hospital, Leeds, UK.

出版信息

Int Wound J. 2005 Jun;2(2):150-60. doi: 10.1111/j.1742-4801.2005.00083.x.

Abstract

The aim of this analysis was to examine the cost-effectiveness of Contreet Foam (A) in comparison with three other commonly used venous leg ulcer treatment protocols: Aquacel Ag (B), Actisorb Silver (C) and Iodoflex (D). A health-economic analysis reflecting the UK treatment practice and cost structure was performed. The analysis was set up to assess the cost of relative wound area reduction over a 4-week treatment period. The model was validated by a UK expert panel consisting of four wound care specialists. To assure that the 4-week model had a realistic link to cost-effectiveness of complete wound healing, a Markov analysis was also performed. Sensitivity analyses were carried out to ensure validity. Protocol A and C proved to be the most effective treatments. The mean relative reduction in wound area after 4 weeks of treatment was 50.2% (protocol A), 23.9% (protocol B), 44.6% (protocol C) and 36.0% (protocol D). Cost-effectiveness ratios showed that protocol A proved to be the most cost-effective treatment, and protocol B the least. The cost per percentage reduction in wound area was 9.50 UK pounds for protocol A, compared to 16.50-17.60 UK pounds for the other treatment options. The cost-effectiveness of complete healing (Markov analysis) and sensitivity analyses confirmed these results. Using Contreet Foam instead of the other dressing alternatives may imply savings of 2.2-4.4 million UK pounds per year to the National Health Service.

摘要

本分析的目的是研究康瑞特泡沫敷料(A)与其他三种常用的下肢静脉溃疡治疗方案:水凝胶银离子敷料(B)、活性银离子敷料(C)和碘伏棉垫(D)相比的成本效益。进行了一项反映英国治疗实践和成本结构的卫生经济分析。该分析旨在评估在4周治疗期内相对伤口面积减少的成本。该模型由一个由四名伤口护理专家组成的英国专家小组进行验证。为确保4周模型与完全伤口愈合的成本效益有现实关联,还进行了马尔可夫分析。进行了敏感性分析以确保有效性。方案A和C被证明是最有效的治疗方法。治疗4周后伤口面积的平均相对减少率分别为:方案A为50.2%,方案B为23.9%,方案C为44.6%,方案D为36.0%。成本效益比表明,方案A被证明是最具成本效益的治疗方法,而方案B最不具成本效益。方案A每减少1%伤口面积的成本为9.50英镑,而其他治疗方案的成本为16.50 - 17.60英镑。完全愈合的成本效益(马尔可夫分析)和敏感性分析证实了这些结果。使用康瑞特泡沫敷料而非其他敷料替代品,每年可能为英国国家医疗服务体系节省220万至440万英镑。

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