TY - JOUR
T1 - Compression Therapy Is Cost-Saving in the Prevention of Lower Limb Recurrent Cellulitis in Patients with Chronic Edema
AU - Webb, Elizabeth
AU - Bissett, Bernie
AU - Neeman, Teresa
AU - Bowden, Francis
AU - Preston, Elisabeth
AU - Mumford, Virginia
N1 - Funding Information:
Total expenditure on compression therapy during the RCT was $50,551 across 41 participants, with health services funding 84% and patients funding the remaining 16%. Government funding schemes differ between countries, and therefore, the proportion of compression therapy expenditure funded by health services may also vary. Health service and patient costs for compression therapy were substantially higher in the first 6 months compared with the following 12 months. This was expected as initiating compression therapy involves multiple appointments for education, and for measurement and fitting of compression garments. Furthermore, some patients also require a series of compression bandages to reduce limb volume before optimal measurement and fit of compression garments. Although these interventions may be required on an ongoing basis to manage chronic edema, the frequency and consequently cost are usually much lower after the initial intensive treatment phase. After the initial 6-month period, the measured 12-month cost of compression therapy per patient, being $887 and $230 from health service and patient perspectives, respectively, may be indicative of ongoing annual costs. Thus, provision of compression therapy has high upfront costs, but ongoing maintenance costs appear to be lower.
Publisher Copyright:
© 2023 Elizabeth Webb et al. Published by Mary Ann Liebert, Inc.
PY - 2023/4/1
Y1 - 2023/4/1
N2 -
Background:
Cellulitis is a common and often recurrent infection that causes substantial financial burden and morbidity. Compression therapy reduces the risk of recurrent cellulitis episodes for adults with chronic edema; however, little is known about the cost-effectiveness of the intervention.
Methods and Results:
A cost analysis was undertaken during a randomized controlled trial (RCT) involving 84 participants with lower limb chronic edema and a history of recurrent cellulitis. The intervention group received compression therapy and education, while the control group received education only. A clinical audit and survey were used to measure health service and patient resource use for (1) the most recent episode of cellulitis, and (2) compression therapy over 18 months. Australian reference costs were used to calculate cellulitis and compression therapy costs, and the mean expenditure in both the RCT groups. Of the 84 RCT participants, 43 were surveyed and audited on the cost of cellulitis, and 40 on the cost of compression therapy. The mean cost of a hospitalized and nonhospitalized episode of cellulitis was $9071 and $506 from a health service perspective, and $4496 and $1320 from a patient perspective. The mean cost of compression therapy per participant over 18 months was $1905 and $421 from health service and patient perspectives, respectively. During the RCT, the mean annual cost per participant was $4972 in the experimental group and $26,382 in the control group, giving a cost-saving of $21,483 (95% confidence interval, 3136-48,176) per participant.
Conclusion:
For patients with lower limb chronic edema and recurrent cellulitis, compression therapy is both efficacious and cost-saving. Trial Registration: ACTRN12617000412336.
AB -
Background:
Cellulitis is a common and often recurrent infection that causes substantial financial burden and morbidity. Compression therapy reduces the risk of recurrent cellulitis episodes for adults with chronic edema; however, little is known about the cost-effectiveness of the intervention.
Methods and Results:
A cost analysis was undertaken during a randomized controlled trial (RCT) involving 84 participants with lower limb chronic edema and a history of recurrent cellulitis. The intervention group received compression therapy and education, while the control group received education only. A clinical audit and survey were used to measure health service and patient resource use for (1) the most recent episode of cellulitis, and (2) compression therapy over 18 months. Australian reference costs were used to calculate cellulitis and compression therapy costs, and the mean expenditure in both the RCT groups. Of the 84 RCT participants, 43 were surveyed and audited on the cost of cellulitis, and 40 on the cost of compression therapy. The mean cost of a hospitalized and nonhospitalized episode of cellulitis was $9071 and $506 from a health service perspective, and $4496 and $1320 from a patient perspective. The mean cost of compression therapy per participant over 18 months was $1905 and $421 from health service and patient perspectives, respectively. During the RCT, the mean annual cost per participant was $4972 in the experimental group and $26,382 in the control group, giving a cost-saving of $21,483 (95% confidence interval, 3136-48,176) per participant.
Conclusion:
For patients with lower limb chronic edema and recurrent cellulitis, compression therapy is both efficacious and cost-saving. Trial Registration: ACTRN12617000412336.
KW - cellulitis
KW - compression
KW - cost
KW - edema
KW - lymphedema
KW - recurrence
UR - http://www.scopus.com/inward/record.url?scp=85144978414&partnerID=8YFLogxK
U2 - 10.1089/lrb.2022.0029
DO - 10.1089/lrb.2022.0029
M3 - Article
C2 - 35997601
SN - 1539-6851
VL - 21
SP - 160
EP - 168
JO - Lymphatic Research and Biology
JF - Lymphatic Research and Biology
IS - 2
ER -