{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:49:01Z","timestamp":1793760541785,"version":"4.6.1"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The provision of guideline\u2010based care for patients with diabetes\u2010related foot ulcers (DFU) in clinical practice is suboptimal. We estimated the cost\u2010effectiveness of higher rates of guideline\u2010based care, compared with current practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The costs and quality\u2010adjusted life\u2010years (QALYs) associated with current practice (30% of patients receiving guideline\u2010based care) were compared with seven hypothetical scenarios with increasing proportion of guideline\u2010based care (40%, 50%, 60%, 70%, 80%, 90% and 100%). Comparisons were made using discrete event simulations reflecting the natural history of DFU over a 3\u2010year time horizon from the Australian healthcare perspective. Incremental cost\u2010effectiveness ratios were calculated for each scenario and compared to a willingness\u2010to\u2010pay of AUD 28,000 per QALY. Probabilistic sensitivity analyses were conducted to incorporate joint parameter uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All seven scenarios with higher rates of guideline\u2010based care were likely cheaper and more effective than current practice. Increased proportions compared with current practice resulted in between AUD 0.28 and 1.84\u00a0million in cost savings and 11\u201356 additional QALYs per 1000 patients. Probabilistic sensitivity analyses indicated that the finding is robust to parameter uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher proportions of patients receiving guideline\u2010based care are less costly and improve patient outcomes. Strategies to increase the proportion of patients receiving guideline\u2010based care are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.14961","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T08:48:20Z","timestamp":1663836500000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Cost\u2010effectiveness of guideline\u2010based care provision for patients with diabetes\u2010related foot ulcers: A modelled analysis using discrete event simulation"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3656-5383","authenticated-orcid":false,"given":"Yuqi","family":"Zhang","sequence":"first","affiliation":[{"name":"Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work Queensland University of Technology  Brisbane Australia"},{"name":"Centre for Data Science Queensland University of Technology  Brisbane Australia"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0046-4126","authenticated-orcid":false,"given":"Hannah E.","family":"Carter","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work Queensland University of Technology  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-7964","authenticated-orcid":false,"given":"Peter A.","family":"Lazzarini","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work Queensland University of Technology  Brisbane 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