Wound Management Innovation Cooperative Research Centre, Brisbane, Queensland, Australia.
Australian Centre for Health Services Innovation (AusHSI), Kelvin Grove, Queensland, Australia.
Int Wound J. 2019 Feb;16(1):112-121. doi: 10.1111/iwj.13000. Epub 2018 Oct 5.
Venous leg ulcers (VLUs) result in substantial economic costs and reduced quality of life (QoL); however, there are few Australian cost estimates, especially using patient-level data. We measured community-setting VLU management costs and the impact on the QoL of affected individuals. VLU patients were recruited from a specialist wound clinic, an outpatient clinic, and two community care clinics in Queensland. Cost data were collected at the baseline visit. QoL (EQ-5D-5L) and wound status data were collected at baseline, 1, 3, and 6 months. Patients were classified into guideline-based/optimal care and usual care groups. Average weekly costs per patient were statistically significantly different between the usual care and optimal care groups-$214.61 and $294.72, respectively (P = 0.04). Baseline average QoL score for an unhealed ulcer was significantly higher in the optimal care group compared with usual care (P = 0.025). Time to healing differed between the usual care group and the optimal care group (P = 0.04), with averages of 3.9 and 2.7 months, respectively. These findings increase the understanding of the costs, QoL, and healing outcomes of VLU care. Higher optimal care costs may be offset by faster time to healing. This study provides data to inform an economic evaluation of guideline-based care for VLUs.
静脉性腿部溃疡 (VLU) 会导致巨大的经济成本和生活质量 (QoL) 下降;然而,澳大利亚的成本估计数据很少,尤其是使用患者层面的数据。我们测量了社区环境下 VLU 管理成本及其对患者 QoL 的影响。VLU 患者从昆士兰州的一家专科伤口诊所、一家门诊诊所和两家社区护理诊所招募。在基线就诊时收集成本数据。在基线、1 个月、3 个月和 6 个月时收集 QoL(EQ-5D-5L)和伤口状况数据。根据指南/最佳护理和常规护理将患者分类。常规护理组和最佳护理组之间的每周每位患者平均成本存在统计学显著差异-$214.61 和 $294.72(P = 0.04)。最佳护理组中未愈合溃疡的基线平均 QoL 评分明显高于常规护理组(P = 0.025)。常规护理组和最佳护理组之间的愈合时间不同(P = 0.04),分别为 3.9 个月和 2.7 个月。这些发现增加了对 VLU 护理成本、QoL 和愈合结果的理解。更高的最佳护理成本可能会因更快的愈合时间而得到弥补。本研究提供了数据,为静脉性腿部溃疡基于指南的护理的经济评估提供了信息。