Tools
ToolsWhitty, Jennifer A., Wagner, Adam P., Kang, Evelyn, Ellwood, David, Chaboyer, Wendy, Kumar, Sailesh, Clifton, Vicki L., Thalib, Lukman and Gillespie, Brigid M. (2023) Cost-effectiveness of closed incision negative pressure wound therapy in preventing surgical site infection among obese women giving birth by caesarean section:An economic evaluation (DRESSING trial). Australian and New Zealand Journal of Obstetrics and Gynaecology, 63 (5). pp. 673-680. ISSN 0004-8666
Preview |
PDF (Aust NZ J Obst Gynaeco - 2023 - Whitty - Cost‐effectiveness of closed incision negative pressure wound therapy in)
- Published Version
Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Background: There is growing evidence regarding the potential of closed incision negative pressure wound therapy (ci-NPWT) to prevent surgical site infections (SSIs) in healing wounds by primary closure following a caesarean section (CS). Aim: To assess the cost-effectiveness of ci-NPWT compared to standard dressings for prevention of SSI in obese women giving birth by CS. Materials and Methods: Cost-effectiveness and cost-utility analyses from a health service perspective were undertaken alongside a multicentre pragmatic randomised controlled trial, which recruited women with a pre-pregnancy body mass index ≥30 kg/m2 giving birth by elective/semi-urgent CS who received ci-NPWT (n = 1017) or standard dressings (n = 1018). Resource use and health-related quality of life (SF-12v2) collected during admission and for four weeks post-discharge were used to derive costs and quality-adjusted life years (QALYs). Results: ci-NPWT was associated with AUD$162 (95%CI −$170 to $494) higher cost per person and an additional $12 849 (95%CI −$62 138 to $133 378) per SSI avoided. There was no detectable difference in QALYs between groups; however, there are high levels of uncertainty around both cost and QALY estimates. There is a 20% likelihood that ci-NPWT would be considered cost-effective at a willingness-to-pay threshold of $50 000 per QALY. Per protocol and complete case analyses gave similar results, suggesting that findings are robust to protocol deviators and adjustments for missing data. Conclusions: ci-NPWT for the prevention of SSI in obese women undergoing CS is unlikely to be cost-effective in terms of health service resources and is currently unjustified for routine use for this purpose.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding Information: We thank all the women who took part, the wider research team, and staff members involved in the trial at the recruitment sites. The trial was funded by the competitive peer‐reviewed grant (APP1081026) from the Australian National Health and Medical Research Council. Jennifer Whitty and Adam Wagner are supported by the United Kingdom's (UK's) National Institute of Health Research (NIHR) Applied Research Collaboration East of England (ARC EoE) program. The views expressed are those of the authors and not necessarily those of the UK's National Health Service (NHS), NIHR or Department of Health and Social Care. Publisher Copyright: © 2023 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists. |
| Uncontrolled Keywords: | caesarean section,cost-effectiveness,economic evaluation,negative pressure wound therapy,surgical site infection,obstetrics and gynaecology ,/dk/atira/pure/subjectarea/asjc/2700/2729 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Centres > Population Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 28 Jan 2025 23:49 |
| Last Modified: | 30 Jan 2025 01:41 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/98322 |
| DOI: |
Downloads
Downloads per month over past year
Actions (login required)
 |
View Item |