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Cost-effectiveness analysis of guideline-based optimal care for venous leg ulcers in Australia

Overview of attention for article published in BMC Health Services Research, June 2018
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2 tweeters

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Title
Cost-effectiveness analysis of guideline-based optimal care for venous leg ulcers in Australia
Published in
BMC Health Services Research, June 2018
DOI 10.1186/s12913-018-3234-3
Pubmed ID
Authors

Qinglu Cheng, Michelle Gibb, Nicholas Graves, Kathleen Finlayson, Rosana E. Pacella

Abstract

Venous leg ulcers (VLUs) are expensive to treat and impair quality of life of affected individuals. Although improved healing and reduced recurrence rates have been observed following the introduction of evidence-based guidelines, a significant evidence-practice gap exists. Compression is the recommended first-line therapy for treatment of VLUs but unlike many other developed countries, the Australian health system does not subsidise compression therapy. The objective of this study is to estimate the cost-effectiveness of guideline-based care for VLUs that includes public sector reimbursement for compression therapy for affected individuals in Australia. A Markov model was designed to simulate the progression of VLU for patients receiving guideline-based optimal prevention and treatment, with reimbursement for compression therapy, and then compared to usual care in each State and Territory in Australia. Model inputs were derived from published literature, expert opinion, and government documents. The primary outcomes were changes to costs and health outcomes from a decision to implement guideline-based optimal care compared with the continuation of usual care. Sensitivity analyses were performed to test the robustness of model results. Guideline-based optimal care incurred lower total costs and improved quality of life of patients in all States and Territories in Australia regardless of the health service provider. We estimated that providing compression therapy products to affected individuals would cost the health system an additional AUD 270 million over 5 years but would result in cost savings of about AUD 1.4 billion to the health system over the same period. An evaluation of unfavourable values for key model parameters revealed a wide margin of confidence to support the findings. This study shows that guideline-based optimal care would be a cost-effective and cost-saving strategy to manage VLUs in Australia. Results from this study support wider adoption of guideline-based care for VLUs and the reimbursement of compression therapy. Other countries that face similar issues may benefit from investing in guideline-based wound care.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 20 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 20 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 7 35%
Student > Bachelor 5 25%
Researcher 3 15%
Student > Master 2 10%
Student > Postgraduate 1 5%
Other 2 10%
Readers by discipline Count As %
Unspecified 7 35%
Medicine and Dentistry 6 30%
Nursing and Health Professions 4 20%
Business, Management and Accounting 1 5%
Economics, Econometrics and Finance 1 5%
Other 1 5%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 October 2019.
All research outputs
#8,227,892
of 13,618,787 outputs
Outputs from BMC Health Services Research
#3,087
of 4,562 outputs
Outputs of similar age
#152,036
of 270,108 outputs
Outputs of similar age from BMC Health Services Research
#1
of 1 outputs
Altmetric has tracked 13,618,787 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,562 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one is in the 29th percentile – i.e., 29% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 270,108 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them