The cost of wound care for a local population in England

Abstract

The objective of this study is to estimate the cost of wound care in a local population of approximately 590 000 using results from a wound care audit carried out in Hull and the East Riding of Yorkshire as a basis. Full results of the audit will be published separately. An audit in June 2005 provided information on patients with wounds and on their treatment. This was combined with representative National Health Service unit costs to produce an estimate of the total cost of wound care in 2005-2006. In all, 1644 patients had a total of 2300 wounds (1.44 per patient). Most (74.1%) were treated in the community by district nurses, 21.2% were treated in hospital and 4.8% were treated in residential or hospice care. More than one in four hospital inpatients (26.8%) had a wound. Median duration was 6-12 weeks. Twenty-four per cent had their wound for 6 months or more, and almost 16% of patients had remained unhealed for a year or longer. One in eight wounds (12.8%) were reported as showing signs of infection. The estimated cost of wound care in 2005-2006 was pound15 million to pound18 million ( pound2.5 million to pound3.1 million per 100 000 population). Caring for patients with wounds required the equivalent of 88.5 full-time nurses and up to 87 hospital beds. Wounds are a significant source of cost to patients as well as the health care system. The most important determinant of cost appears to be wound complications which require hospitalisation or which delay hospital discharge. Reducing costs requires a systematic focus on effective and timely diagnosis, on ensuring treatment is appropriate to the cause and condition of the wound and on active measures to prevent complications and wound-related hospitalisation. These results should be generalisable to other similar populations in the UK and elsewhere.

The prevalence, aetiology and management of wounds in a community care area in Ireland

“…A previous Irish study also recorded a substantially high percentage (42%) of undiagnosed leg ulcers (McDermott-Scales, 2009). These figures were similar in the UK, where 26% of wounds classified as leg or foot ulcers had no definite diagnosis (Drew et al, 2007). Leg ulceration is a considerable health problem in Ireland, having a debilitating effect on clients and a substantial effect on health-care budgets (HSE, 2009).Therefore, individuals need to be correctly and efficiently assessed to provide the most appropriate treatment, ensuring cost effective, evidence-based wound care (Clarke-Maloney et al, 2008;Coldridge-Smith, 2009).…”

“…A lack of an accurate assessment and diagnosis impacts negatively on good clinical outcomes being achieved in individuals with leg ulceration. Furthermore, this will increase the financial cost of these problematic wounds to the health-care service, while also adding to the psychological, physical and social impact that these wounds place upon the individual (Drew et al, 2007;Clarke-Maloney et al, 2008;HSE, 2009;Chandan et al, 2009). …”

“…There has been an increasing awareness of costs related to wound care in recent years, but economic analyses are still largely lacking (Drew et al, 2007;Posnett and Franks, 2007). This survey found the average time required for both travel and wound management, and, when calculated with the frequency of dressing changes, the final figure for the time community nurses spend on wound care provision was calculated to be 374 hours a week.…”

“…The ultimate goal of educating CRGNs and PHNs in wound care must be to improve patient outcomes. A structured programme of training for practitioners involved in wound care, supported by best practice guidelines, has the potential to reduce the variation in clinical practice and improve patient outcomes (Drew et al, 2007;Clarke-Maloney et al, 2008;Colridge-Smith, 2009;Moffatt et al, 2009). …”

“…As leg ulceration is frequently chronic and relapsing in nature, it is essential that patients have early access to diagnostic and vascular assessments so that the best possible outcomes are achieved and patient suffering is reduced (Drew et al, 2007;HSE, 2009;Moffatt et al, 2009). Inappropriate management compounds fiscal challenges and exacerbates the S19 Community Wound Care June 2014 negative impact that the presence of these wounds has on client and community nursing service resources (Clarke-Maloney, 2006;Drew et al, 2007;Jorgensen, 2008;Vowden and Vowden, 2008;Gethin, 2009). …”