KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Int Wound J. 2020 Dec;17(6):1791-1808. doi: 10.1111/iwj.13468. Epub 2020 Jul 27.
Continuous delivery of oxygen therapy has been observed to improve healing for individuals with an advanced diabetic foot ulcer (DFU). However, this intervention requires the purchasing of an oxygen delivery device and moist dressings. It is unknown whether this upfront financial investment represents good value for money. Thus the aim of this project is to evaluate the cost-effectiveness of treating advanced DFU using continuous delivery of oxygen compared with negative pressure wound therapy from the perspective of the public health care payer in Ontario, Canada. A microsimulation model was constructed with inputs from peer-reviewed journal publications and publicly available reports. The 5-year costs and quality-adjusted life-years were compared between treatment and comparator. Sensitivity analyses were conducted to evaluate the robustness of results. The model predicted that continuous delivery of oxygen would cost $4800 less compared with negative pressure wound therapy and increased quality-adjusted life years by 0.025. Lower cost and improved outcomes were observed in most scenario analyses. The results of this economic evaluation suggest that CDO therapy may reduce health care economic burden with a modest increase in quality of life outcomes. Health care decision-makers should consider the inclusion of CDO for the treatment of DFU.
持续供氧治疗已被观察到可改善晚期糖尿病足溃疡（DFU）患者的愈合情况。然而，这种干预措施需要购买供氧设备和湿性敷料。目前尚不清楚这种前期的财务投资是否物有所值。因此，本项目旨在从加拿大安大略省公共医疗保健支付者的角度评估使用持续供氧治疗晚期 DFU 的成本效益，与负压伤口治疗进行比较。该模型使用同行评议的期刊出版物和公开报告中的数据进行构建。比较了治疗组和对照组之间 5 年的成本和调整后质量生命年。进行了敏感性分析以评估结果的稳健性。该模型预测，与负压伤口治疗相比，持续供氧治疗的成本将降低 4800 加元，并且调整后质量生命年将增加 0.025。在大多数方案分析中，均观察到较低的成本和改善的结果。这项经济评估的结果表明，CDO 治疗可能会降低医疗保健的经济负担，同时适度提高生活质量。医疗保健决策者应考虑将 CDO 纳入 DFU 的治疗。
