Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
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54 Hyperbaric Oxygenation Therapy <strong>KCE</strong> Reports 74<br />
As mentioned by Fife et al., 130 for the treatment of lower-extremity lesions, rather than<br />
complete healing of a lesion, the objective today is more often a partial healing by<br />
granulation to the point that epithelization can continue without further hyperbaric<br />
therapy. As a consequence, achieving the complete healing category might not be the<br />
best objective for cost-effective treatment of patients with HBOT. 130<br />
4.5 CONCLUSION<br />
HBOT may provide several benefits such as reducing length of hospital stay, reduction<br />
in amputations, improvement in patients QoL, reduction in outpatient care, etc.<br />
According to several authors, this could result both in increasing benefits and<br />
decreasing costs, resulting in a cost saving treatment. For example, it seems that HBOT<br />
could be cost-effective in the treatment of diabetic wounds. All studies, however, show<br />
limitations for both incremental cost and benefit calculations. Therefore, they can only<br />
be seen as an indication that HBOT may be a cost-effective treatment. They do not<br />
provide good evidence that HBOT is a cost-effective treatment. The suggestion that<br />
HBOT could be clinically effective, could improve QoL, and could reduce health care<br />
costs in certain indications highlights the need for further large multi-centre trials to find<br />
out whether or not this is the case. While evidence data would be collected, good cost<br />
data should also be gathered. Incremental costs and benefits which are part of both the<br />
short- and long-term treatment pathway should be taken into account. As long as good<br />
qualitative evidence and cost data are lacking, good qualitative economic evaluations can<br />
not be performed.<br />
Key points<br />
• Being an adjunct to standard therapy, HBOT is associated with increased<br />
(initial) treatment costs.<br />
• Even though potential harms caused by HBOT appear to be small, it is a<br />
waste of valuable resources to use HBOT for conditions for which it is not<br />
effective.<br />
• Economic evaluations currently are based on insufficient data and<br />
therefore have important limitations for both the incremental cost and<br />
benefit calculations.<br />
• It is not possible to estimate cost-effectiveness of HBOT without good<br />
data on effectiveness, costs and quality of life.<br />
• HBOT might be effective, improve QoL, and reduce costs in certain<br />
indications. Therefore, it deserves further attention and there is need for<br />
large multi-centre trials to gather both short- and long-term evidence<br />
and cost data.