Components of the Direct Cost of Topical Treatment for Chronic Wounds in Adults and Elderly: A Systematic Review
Author(s)
Ramon A. Oliveira, MSc, RN, ScD1, Silvia Regina Secoli, PhD, Professor2.
1Professor, University of São Paulo, São Paulo, Brazil, 2Universidade de São Paulo, Escola de Enfermagem, São Paulo, Brazil.
1Professor, University of São Paulo, São Paulo, Brazil, 2Universidade de São Paulo, Escola de Enfermagem, São Paulo, Brazil.
OBJECTIVES: To analyze the constituent categories of the direct cost of treating diabetic foot and venous ulcers in adult and elderly patients receiving home, outpatient, or hospital care.
METHODS: Systematic literature review conducted in accordance with PRISMA guidelines. The databases PubMed/Medline, Embase, CINAHL, Scopus, Web of Science, LiLACS, EconLit, and the Cochrane Database of Systematic Reviews were searched. Economic studies addressing all topical interventions used in chronic wounds in adults or the elderly were included. Studies focusing on compression therapy or pressure injuries were excluded.
RESULTS: A total of 4,015 records were retrieved, of which 35 studies were included in this review. The investigations were published between 1994 and 2002, with most (94.3%) published in English. The United Kingdom was the most frequent country of origin (34.3%), and the Journal of Wound Care had the highest number of publications (25.7%). The majority of studies did not report using methodological guidelines (88.6%), and cost-effectiveness analyses comprised the most common study design (51.4%). The most studied wound types were venous ulcers (62.8%) and diabetic foot ulcers (22.8%), primarily in outpatient settings (57.1%) and from the perspective of the National Health Service (51.4%). The most frequently reported cost categories were: dressings (85.7%), supplies for wound care (62.8%), nursing time (57.1%), and nurse visit and travel (42.8%). Micro-costing data were reported in only one study. Measures of effectiveness included: healing rate (25.7%), quality of life (17.1%), and number of ulcer-free days (2.8%).
CONCLUSIONS: Cost-effectiveness evaluations are primarily focused on venous and diabetic foot ulcers, with an emphasis on outpatient care and healthcare system perspectives. Although the cost categories included in the studies were broad, a major limitation lies in the lack of micro-costing elements and standardization in scientific reporting. Therefore, future research should prioritize standardized approaches to enhance the knowledge base and its applicability.
METHODS: Systematic literature review conducted in accordance with PRISMA guidelines. The databases PubMed/Medline, Embase, CINAHL, Scopus, Web of Science, LiLACS, EconLit, and the Cochrane Database of Systematic Reviews were searched. Economic studies addressing all topical interventions used in chronic wounds in adults or the elderly were included. Studies focusing on compression therapy or pressure injuries were excluded.
RESULTS: A total of 4,015 records were retrieved, of which 35 studies were included in this review. The investigations were published between 1994 and 2002, with most (94.3%) published in English. The United Kingdom was the most frequent country of origin (34.3%), and the Journal of Wound Care had the highest number of publications (25.7%). The majority of studies did not report using methodological guidelines (88.6%), and cost-effectiveness analyses comprised the most common study design (51.4%). The most studied wound types were venous ulcers (62.8%) and diabetic foot ulcers (22.8%), primarily in outpatient settings (57.1%) and from the perspective of the National Health Service (51.4%). The most frequently reported cost categories were: dressings (85.7%), supplies for wound care (62.8%), nursing time (57.1%), and nurse visit and travel (42.8%). Micro-costing data were reported in only one study. Measures of effectiveness included: healing rate (25.7%), quality of life (17.1%), and number of ulcer-free days (2.8%).
CONCLUSIONS: Cost-effectiveness evaluations are primarily focused on venous and diabetic foot ulcers, with an emphasis on outpatient care and healthcare system perspectives. Although the cost categories included in the studies were broad, a major limitation lies in the lack of micro-costing elements and standardization in scientific reporting. Therefore, future research should prioritize standardized approaches to enhance the knowledge base and its applicability.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE148
Topic
Economic Evaluation, Epidemiology & Public Health, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas