COMMUNITY LEG ULCER CLINICS - A COMPARATIVE-STUDY IN 2 HEALTH AUTHORITIES

Objective-To compare the outcome and cost of care for leg ulcers in co mmunity leg ulcer clinics in Stockport District Health Authority with Trafford District Health Authority as a control. Design-Detailed cost and efficacy studies conducted prospectively over a three month period in both districts both before and one year after the introduction of five leg ulcer clinics in Stockport. Setting-Two large district health authorities of broad-socioeconomic mix and total population of 540 00 0. Patients-All patients receiving treatment for an active leg ulcer, irrespective of the profession or location of their carer. Main outcom e measures-The proportion of ulcerated limbs completely healed within three months and total cost of leg ulcer care. Results-The introductio n of community clinics in Stockport improved healing of leg ulcers fro m 66/252 (26%) in 1993 to 99/233 (42%) in 1994 (P<0.001) compared with in Trafford, where 47/203 (23%) healed in 1993 and only 43/213 (20%) in 1994. This improved result in Stockport was achieved while the annu al expenditure on care of leg ulcers was reduced from pound 409 991 to only pound 253 371. In the same year the cost of leg ulcer care in Tr afford increased from pound 556 039 to pound 673 318. Conclusion-In th e first year after the introduction of community clinics, before most patients in Stockport had access to these clinics, healing of leg ulce rs was already improved whereas costs were reduced.