Cost-effectiveness research in wound care: definitions, approaches, and limitations.

The value of cost-effectiveness research in all areas of healthcare, including wound care, is increasing. The purpose of this narrative review is to discuss and critically examine economic analysis methods and determine how current knowledge should be applied to wound care. Unlike evidence-based medicine, there is less agreement on how to conduct economic analyses in healthcare and universal guidelines for reporting these studies are lacking. A review of the literature shows that, in wound care, economic analysis is mostly limited to cost-benefit analysis with a limited time horizon; several examples specific to venous ulcers are presented. In addition, most analyses are models based on prospective studies; this is an especially important consideration because chronic wounds may take a long time to heal and/or recur. Other economic analyses that may be very useful to evaluate include those based on "real world" or practice-based studies, which provide results for all wound care populations and can be compared to facilitate development of cost-effective strategies for wound care treatment. Currently available cost-effectiveness study results may help healthcare providers devise cost-effectiveness strategies to embed in clinical practice guidelines that will save costs and improve patient quality of life.