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dc.contributor.authorTuffaha, Haitham W
dc.contributor.authorRoberts, Shelley
dc.contributor.authorChaboyer, Wendy
dc.contributor.authorGordon, Louisa G
dc.contributor.authorScuffham, Paul A
dc.date.accessioned2018-01-23T00:36:53Z
dc.date.available2018-01-23T00:36:53Z
dc.date.issued2015
dc.identifier.issn1175-5652
dc.identifier.doi10.1007/s40258-015-0152-y
dc.identifier.urihttp://hdl.handle.net/10072/117195
dc.description.abstractBACKGROUND: Pressure ulcers are a major cause of mortality, morbidity, and increased healthcare cost. Nutritional support may reduce the incidence of pressure ulcers in hospitalised patients who are at risk of pressure ulcer and malnutrition. OBJECTIVES: To evaluate the cost-effectiveness of nutritional support in preventing pressure ulcers in high-risk hospitalised patients, and to assess the value of further research to inform the decision to implement this intervention using value of information analysis (VOI). METHODS: The analysis was from the perspective of Queensland Health, Australia using a decision model with evidence derived from a systematic review and meta-analysis. Resources were valued using 2014 prices and the time horizon of the analysis was one year. Monte Carlo simulation was used to estimate net monetary benefits (NB) and to calculate VOI measures. RESULTS: Compared with standard hospital diet, nutritional support was cost saving at AU$425 per patient, and more effective with an average 0.005 quality-adjusted life years (QALY) gained. At a willingness-to-pay of AU$50,000 per QALY, the incremental NB was AU$675 per patient, with a probability of 87 % that nutritional support is cost-effective. The expected value of perfect information was AU$5 million and the expected value of perfect parameter information was highest for the relative risk of developing a pressure ulcer at AU$2.5 million. For a future trial investigating the relative effectiveness of the interventions, the expected net benefit of research would be maximised at AU$100,000 with 1,200 patients in each arm if nutritional support was perfectly implemented. The opportunity cost of withholding the decision to implement the intervention until the results of the future study are available would be AU$14 million. CONCLUSIONS: Nutritional support is cost-effective in preventing pressure ulcers in high-risk hospitalised patients compared with standard diet. Future research to reduce decision uncertainty is worthwhile; however, given the opportunity losses associated with delaying the implementation, "implement and research" is the approach recommended for this intervention.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherAdis International
dc.publisher.placeNew Zealand
dc.relation.ispartofpagefrom167
dc.relation.ispartofpageto179
dc.relation.ispartofissue2
dc.relation.ispartofjournalApplied Health Economics and Health Policy
dc.relation.ispartofvolume13
dc.subject.fieldofresearchAcute care
dc.subject.fieldofresearchApplied economics
dc.subject.fieldofresearchMarketing
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchPolicy and administration
dc.subject.fieldofresearchcode420501
dc.subject.fieldofresearchcode3801
dc.subject.fieldofresearchcode3506
dc.subject.fieldofresearchcode4206
dc.subject.fieldofresearchcode4407
dc.titleCost-Effectiveness and Value of Information Analysis of Nutritional Support for Preventing Pressure Ulcers in High-risk Patients: Implement Now, Research Later
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.facultyGriffith Health, School of Medicine
gro.hasfulltextNo Full Text
gro.griffith.authorChaboyer, Wendy
gro.griffith.authorScuffham, Paul A.
gro.griffith.authorRoberts, Shelley J.


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