Cost effectiveness of community leg ulcer clinics: randomised controlled trial

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

Full content URL:

23237 1487.full.pdf
23237 1487.full.pdf - Whole Document
Available under License Creative Commons Attribution.

Item Type:Article
Item Status:Live Archive


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.

Keywords:Health, Trial
Subjects:L Social studies > L510 Health & Welfare
Divisions:College of Social Science > School of Health & Social Care
Related URLs:
ID Code:23237
Deposited On:09 Jun 2016 14:35

Repository Staff Only: item control page