Evaluating the cost-effectiveness of diabetic foot ulcer management by wound care specialists in Indonesia.

Autor: Jais S; Graduate Nursing Program, Institut Teknologi dan Kesehatan Muhammadiyah Kalbar, Pontianak, Kalimantan Barat, Indonesia., Oe M; Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan., Sanada H; Ishikawa Prefectural Nursing University, Kahoku-gun, Ishikawa, Japan., Sasongko A; Program Studi Manajemen Informatika, Universitas Bina Sarana Informatika, Pontianak, Indonesia., Haryanto H; Graduate Nursing Program, Institut Teknologi dan Kesehatan Muhammadiyah Kalbar, Pontianak, Kalimantan Barat, Indonesia.
Jazyk: angličtina
Zdroj: Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society [Wound Repair Regen] 2024 Jan-Feb; Vol. 32 (1), pp. 80-89. Date of Electronic Publication: 2024 Jan 08.
DOI: 10.1111/wrr.13147
Abstrakt: Diabetic foot ulcers affect quality of life and economically burden patients and the Indonesian healthcare system. The comparative cost-effectiveness of wound care specialists in private practices (e.g., wound clinics) and wound care nurses in national hospitals remains unknown. Thus, we used a decision tree to compare the cost and healing rates for patients after 12 weeks of wound care. Uncertainty was addressed using one-way and probabilistic sensitivity analyses. Among 89 participants (42 in the national hospital and 47 in the private practice), no significant differences were observed between the two groups in terms of sex, age, education level, smoking status, duration of diabetes, Wagner wound classification, glycated haemoglobin levels, neuropathy status, ankle-brachial index, baseline characteristics, quality of life, DMIST (depth, maceration, inflammation/infection, size, tissue type of the wound bed, type of wound edge, and tunnelling/undermining) score and wound location (p > 0.05). However, significant differences were observed for days from first visit/assessment until complete healing, mean quality of life (p ≤ 0.001) and wound size (p = 0.047). Wound care specialists in private practices had a significantly lower cost of 2,804,423.3 Indonesian rupiah compared to 6,483,493.4 Indonesian rupiah for wound care nurses in national hospitals. The incremental cost-effectiveness ratio was -165,723.9. Therefore, wound care specialists in private practices are more cost-effective for managing diabetic foot ulcers. Probability sensitivity analysis confirmed that 80%-90% of the scenarios were cost-effective. These findings may inform healthcare resource allocation in Indonesia. Additionally, evidence-based cost-effectiveness measures were strengthened in private practices and national hospitals.
(© 2023 The Wound Healing Society.)
Databáze: MEDLINE
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