A cost-effectiveness analysis of two community models of care for patients with venous leg ulcers.
OBJECTIVE
To conduct a cost-effectiveness analysis based on data from a randomised controlled trial comparing traditional community home nursing with a community Leg Club model for chronic venous leg ulcer management in the south-east metropolitan area of Queensland, Australia.


METHODS
Participants were randomised to the Leg Club (n=28) or home visits (n=28). Data were obtained on resources/related costs incurred by the service provider, clients and carers, and the community.


RESULTS
From the collective perspective (service provider, clients and carers, and the community), at six months the incremental cost per healed ulcer was dollars AU515 (Euros 318) and the incremental cost per reduced pain score was dollars AU322 (Euros 199). For the service provider, Leg Club intervention resulted in cost savings and better health effects when compared with home nursing.


CONCLUSIONS
On both clinical and economic grounds, the Leg Club model appears to be more cost-effective than traditional home nursing for the treatment of chronic venous leg ulcers. However, clients and the local community contribute substantial financial and in-kind support to the operation of both services.
Gordon
L
L
Institute of Health and Biomedical Innnovation School of Nursing, Queensland University of Technology, Brisbane, Australia. louisagordon@qldcancer.com.au
Edwards
H
H
Courtney
M
M
Finlayson
K
K
Shuter
P
P
Lindsay
E
E
D000368:Aged; D002908:Chronic Disease; D003151:Community Health Centers / Q000458:organization & administration*; D003152:Community Health Nursing / Q000458:organization & administration*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006792:House Calls / Q000191:economics*; D006801:Humans; D008297:Male; D016294:Models, Nursing; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D015397:Program Evaluation; D011793:Queensland; D012657:Self-Help Groups / Q000458:organization & administration*; D017592:Skin Care / Q000191:economics / Q000379:methods / Q000451:nursing; D014195:Travel / Q000191:economics; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000150:complications / Q000451:nursing* / Q000523:psychology; D014945:Wound Healing