dc.contributor.author | Heard, Christopher | |
dc.contributor.author | Chaboyer, Wendy | |
dc.contributor.author | Anderson, Vinah | |
dc.contributor.author | Gillespie, Brigid M | |
dc.contributor.author | Whitty, Jennifer A | |
dc.date.accessioned | 2017-11-23T03:10:56Z | |
dc.date.available | 2017-11-23T03:10:56Z | |
dc.date.issued | 2017 | |
dc.identifier.issn | 0965-206X | |
dc.identifier.doi | 10.1016/j.jtv.2016.06.001 | |
dc.identifier.uri | http://hdl.handle.net/10072/143301 | |
dc.description.abstract | Background: 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.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | Elsevier | |
dc.relation.ispartofpagefrom | 1 | |
dc.relation.ispartofpageto | 6 | |
dc.relation.ispartofjournal | Journal of Tissue Viability | |
dc.subject.fieldofresearch | Clinical sciences | |
dc.subject.fieldofresearch | Clinical sciences not elsewhere classified | |
dc.subject.fieldofresearch | Allied health and rehabilitation science | |
dc.subject.fieldofresearchcode | 3202 | |
dc.subject.fieldofresearchcode | 320299 | |
dc.subject.fieldofresearchcode | 4201 | |
dc.title | Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
gro.description.notepublic | This publication has been entered into Griffith Research Online as an Advanced Online Version. | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Chaboyer, Wendy | |
gro.griffith.author | Gillespie, Brigid M. | |