Morrell, C.J., Walters, S.J., Dixon, S., Collins, K.A., Brereton, L.M.L., Peters, J. and Brooker, C.G.D. (1998) Cost effectiveness of community leg ulcer clinics: randomised controlled trial. BMJ, 316 (7143). pp. 1487-1491. ISSN 0959-8138
Objectives: To establish the relative cost effectiveness of community leg ulcer clinics that use four layer compression bandaging versus usual care provided by district nurses.
Design: Randomised controlled trial with 1 year of follow up.
Setting: Eight community based research clinics in four trusts in Trent.
Subjects: 233 patients with venous leg ulcers allocated at random to intervention (120) or control (113) group.
Interventions: Weekly treatment with four layer bandaging in a leg ulcer clinic (clinic group) or usual care at home by the district nursing service (control group).
Main outcome measures: Time to complete ulcer healing, patient health status, and recurrence of ulcers. Satisfaction with care, use of services, and personal costs were also monitored.
Results: The ulcers of patients in the clinic group tended to heal sooner than those in the control group over the whole 12 month follow up (log rank P=0.03). At 12 weeks, 34% of patients in the clinic group were healed compared with 24% in the control. The crude initial healing rate of ulcers in intervention compared with control patients was 1.45 (95% confidence interval 1.04 to 2.03). No significant differences were found between the groups in health status. Mean total NHS costs were £878.06 per year for the clinic group and £859.34 for the control (P=0.89).
Conclusions: Community based leg ulcer clinics with trained nurses using four layer bandaging is more effective than traditional home based treatment. This benefit is achieved at a small additional cost and could be delivered at reduced cost if certain service configurations were used.
|Copyright, Publisher and Additional Information:||© BMJ 1998. Reproduced in accordance with the publisher's self-archiving policy.|
|Institution:||The University of Sheffield|
|Academic Units:||The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Nursing and Midwifery (Sheffield)
The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield)
|Depositing User:||Repository Officer|
|Date Deposited:||12 Sep 2006|
|Last Modified:||05 Jun 2014 23:44|
|Publisher:||British Medical Journal Publishing Group|