Cost effectiveness in wound care.

Universal, objective definitions or formulas have not been available for calculating the costs of wounds and measuring cost/benefits of different care methods. Therefore, it is difficult to compare cost effectiveness of different treatments. A literature review revealed confusion concerning the differences between "cost" and "cost effectiveness". The costs of wound care are divided into direct costs (i.e., costs of supplies, surgical interventions, medications, inpatient care) and indirect costs (i.e., assistance with activities of daily living, days lost from work, litigation). Studies of cost effectiveness should measure cost per unit outcome. In wound care studies, outcomes are usually measured according to the goals of treatment. Common problems with published cost effectiveness studies are that cost is often confused with cost effectiveness; there is no standard method of calculating wound care costs; few studies have measured costs to achieve measured treatment outcomes; and outcomes are often measured or reported differently from study to study. In view of this, it is impossible to clarify cost effectiveness of healing, debridement, pain relief, etc. Until universal, objective scales to measure cost effectiveness are available, the clinician must read published studies critically to determine if treatment measures are indeed cost effective.