Health service costs of treating venous leg ulcers in the UK: evidence from a cross-sectional survey based in the north west of England

Abstract

ObjectivesTo estimate and examine the direct healthcare costs of treating people with open venous leg ulcers in the UK.DesignCost-of-illness study.SettingA cross-sectional survey of nine National Health Service community locales over 2-week periods in 2015/2016.MethodsWe examined the resource use and prevalence of venous leg ulcer treatment in the community. Examination of variation in these obtained costs was performed by ordinary least squares regression. We used additional resource use information from a randomised control trial and extrapolated costs to the UK for an annual period.ResultsThe average 2-week per person cost of treating patients where a venous leg ulceration was the primary (most severe) wound was estimated at £166.39 (95% CI £157.78 to £175.00) with community staff time making up over half of this amount. Costs were higher where antimicrobial dressings were used and where wound care was delivered in the home. Among those with any recorded venous leg ulcer (primary and non-primary), we derived a point prevalence of 3.2 per 10 000 population and estimated that the annual prevalence could be no greater than 82.4 per 10 000 population. We estimated that the national cost of treating a venous leg ulcer was £102 million with a per person annual cost at £4787.70.ConclusionOur point prevalence figures are in line with the literature. However, our annual prevalence estimations and costs are far lower than those reported in recent literature which suggests that the costs of treating venous leg ulcers are lower than previously thought. Movement towards routinely collected and useable community care activity would help provide a transparent and deeper understanding of the scale and cost of wound care in the UK.

Best practice, best products, best outcomes in community wound care: three descriptive cohorts

“…Cohort 3B analysis also showed that VLU were equal second with mixed vascular aetiology leg ulcers insofar as being the most costly chronic wound to treat (Table 5, median A$495/wound). This is broadly consistent with other VLU literature 16,29 .…”

“…Collectively, Silverchain nurses managed 41,865 clients with 88,793 wounds. This finding confirms the large number of wounds treated in the community and that wound management often comprises the largest portion of community nurses' workload [13][14][15] and associated costs 16 . It has been previously reported that 70-80% of wounded individuals are treated in the community, and predominately by community nurses who spend 60% of time involved in these activities 7 .…”

How health literacy relates to venous leg ulcer healing: A scoping review

“…The prevalence of VLU increases with age, doubling among those aged over 65 years [ 4 , 6 ] The typical VLU patient tends to be female, over 65 years old, has a high risk of cardiovascular events, and has obesity [ 7 ]. VLU patients often face ongoing health and quality of life problems [ 6 , 8 ] partially because the treatment itself requires substantial self-management, leading to significant intrapersonal and interpersonal burdens [ 3 , 6 , 9 ].…”

“…VLUs are a chronic skin condition of the lower limbs, often affecting the elderly and those with chronic health illnesses [1,2]. VLUs affect approximately 1-3% of adults globally [2][3][4]. Furthermore, these wounds tend to be severe; recent evidence suggests that almost 20% of wounds present in aged community samples are VLUs [5].…”

Journal of Wound Management November 2022

“…Although diabetes is the leading cause of death associated with chronic ulcers, it is important to note that the mortality risk for those with leg ulcers of any aetiology is greater than controls (9). In addition, due to the high prevalence of chronic ulcers in the UK, affecting nearly 1% of the population and with a point prevalence of 3.2 per 10,000 (10), there is also a great financial burden associated. The cost of chronic wound treatment has been estimated to cost the UK around £100 million-£2 billion annually (10,11) and is expected to reach up to £65 billion across the world by 2024 (12,13).…”