Health economic burden that wounds impose on the National Health Service in the UK

Abstract

ObjectiveTo estimate the prevalence of wounds managed by the UK's National Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource use attributable to their management and corresponding costs.MethodsThis was a retrospective cohort analysis of the records of patients in The Health Improvement Network (THIN) Database. Records of 1000 adult patients who had a wound in 2012/2013 (cases) were randomly selected and matched with 1000 patients with no history of a wound (controls). Patients’ characteristics, wound-related health outcomes and all healthcare resource use were quantified and the total NHS cost of patient management was estimated at 2013/2014 prices.ResultsPatients’ mean age was 69.0 years and 45% were male. 76% of patients presented with a new wound in the study year and 61% of wounds healed during the study year. Nutritional deficiency (OR 0.53; p<0.001) and diabetes (OR 0.65; p<0.001) were independent risk factors for non-healing. There were an estimated 2.2 million wounds managed by the NHS in 2012/2013. Annual levels of resource use attributable to managing these wounds and associated comorbidities included 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds and associated comorbidities was £5.3 billion. This was reduced to between £5.1 and £4.5 billion after adjusting for comorbidities.ConclusionsReal world evidence highlights wound management is predominantly a nurse-led discipline. Approximately 30% of wounds lacked a differential diagnosis, indicative of practical difficulties experienced by non-specialist clinicians. Wounds impose a substantial health economic burden on the UK's NHS, comparable to that of managing obesity (£5.0 billion). Clinical and economic benefits could accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients and the NHS.

Development of a generic wound care assessment minimum data set

“…The development of the MDS has sought to address concerns over inadequate wound assessment practice [7] by providing a framework upon which healthcare provider organisations can base their assessment documentation. However, the MDS can only provide a starting point for improving care and measures to encourage implementation are needed.…”

“…In the United States, chronic wounds affect approximately 6.5 million patients with an estimated $25 billion treatment cost per annum [6]. This is also reflected in the United Kingdom where recent information from the Health Improvement Network (THIN) Database which collects data from primary care, indicated 4.5% (2.2 million) of the adult population were estimated to have a wound (excluding surgical wounds that healed within 4 weeks of the procedure) in 2012/13, accounting for 40.6 million healthcare professional/patient visits, 97.1 million drug prescriptions, 344.6 million dressings/ bandages and costing £4.5e5.1 billion [7]. The study also found that 12% of wounds had no recorded diagnosis and 56% of the wounds recoded as leg ulcers lacked a differential diagnosis, suggesting a lack of evidence-based wound care/assessment [7].…”

Polymeric optical fibre sensor coated by SiO2 nanoparticles for humidity sensing in the skin microenvironment

“…Chronic wounds are a major global healthcare problem placing a considerable economic burden on the resources of healthcare providers. For example, in the UK alone, a recent analysis of the health economic burden of wounds [3] highlighted that ~2.2 million wounds were managed by the publicly funded National Health Service (NHS) in 2012/2013 requiring 18.6 million practice nurse, 10.9 million community nurse, 7.7 million GP and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds is £4.5-5.1 billion (~4% of the entire NHS budget).…”

Evaluating the impact of WaterCell ® Technology on pressure redistribution and comfort/discomfort of adults with limited mobility

“…These pressure ulcers impose a substantial health economic burden on the United Kingdom's (UK) National Health Service. Guest et al (2015) Stockton, Gebhardt, and Clark (2009) found that guidance for people whilst seated is significantly less comprehensive.…”