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dc.contributor.authorHeard, Christopher
dc.contributor.authorChaboyer, Wendy
dc.contributor.authorAnderson, Vinah
dc.contributor.authorGillespie, Brigid M
dc.contributor.authorWhitty, Jennifer A
dc.date.accessioned2017-11-23T03:10:56Z
dc.date.available2017-11-23T03:10:56Z
dc.date.issued2017
dc.identifier.issn0965-206X
dc.identifier.doi10.1016/j.jtv.2016.06.001
dc.identifier.urihttp://hdl.handle.net/10072/143301
dc.description.abstractBackground: Negative pressure wound therapy (NPWT) is increasingly used prophylactically following surgery despite limited evidence of clinical or cost-effectiveness. Objective: To evaluate whether NPWT is cost-effective compared to standard care, for the prevention of surgical site infection (SSI) in obese women undergoing elective caesarean section, and inform development of a larger trial. Methods: An economic evaluation was conducted alongside a pilot randomised controlled trial at one Australian hospital, in which women were randomised to NPWT (n = 44) or standard care (n = 43). A public health care provider perspective and time horizon to four weeks post-discharge was adopted. Cost-effectiveness assessment was based on incremental cost per SSI prevented and per quality-adjusted life year (QALY) gained. Results: Patients receiving NPWT each received health care costing AU$5887 (±1038) and reported 0.069 (±0.010) QALYs compared to AU$5754 (±1484) and 0.066 (±0.010) QALYs for patients receiving standard care. NPWT may be slightly more costly and more effective than standard care, with estimated incremental cost-effectiveness ratios (ICERs) of AU$1347 (95%CI dominant- $41,873) per SSI prevented and AU$42,340 (95%CI dominant- $884,019) per QALY gained. However, there was considerable uncertainty around these estimates. Conclusions: NPWT may be cost-effective in the prophylactic treatment of surgical wounds following elective caesarean section in obese women. Larger trials could clarify the cost-effectiveness of NPWT as a prophylactic treatment for SSI. Sensitive capture of QALYs and cost offsets will be important given the high level of uncertainty around the point estimate cost-effectiveness ratio which was close to conventional thresholds.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofpagefrom1
dc.relation.ispartofpageto6
dc.relation.ispartofjournalJournal of Tissue Viability
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchClinical sciences not elsewhere classified
dc.subject.fieldofresearchAllied health and rehabilitation science
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode320299
dc.subject.fieldofresearchcode4201
dc.titleCost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.hasfulltextNo Full Text
gro.griffith.authorChaboyer, Wendy
gro.griffith.authorGillespie, Brigid M.


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