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The Economic cost of wounds

Economic Cost of Wounds

The economic cost of wounds is measured in literally billions of dollars, euros and pounds. Health system managers may be unaware of this cost as much of it is “hidden”, in that it’s not apparent in the cost of materials.

Current estimates indicate that wounds account for almost 4% of total health system costs, and that this proportion is increasing.5

Hospitalisation itself is the main cost driver for wound care for the system. As patients cannot be discharged until healing is well advanced, delays in wound closure will have a significant cost impact in bed days and other associated resources within the health system.

Nursing time is another factor that far outweighs the cost of materials. This valuable resource could be deployed in other ways to the benefit of their patients, or used to increase the capability of the system to treat more patients.

 

 

Reducing the Hidden Cost of Wound Care:
Dressing Changes

The resources involved in the apparently simple act of changing dressings should not be under estimated. A study in Uppsala, Sweden, showed that in a community of 288,000 people, with a typical wound prevalence of 2.4/1000, the equivalent 57 full-time nurses were required for dressing changes alone.6

In the acute setting, dressing-change frequency is a big factor in the deployment of nursing resource. Choice of dressing is therefore a vital consideration, and one that should not be based on the unit cost alone.

Dressings that require fewer changes produce patient benefits, as they reduce trauma; clinical benefits, as the wound is exposed to contaminants less frequently; and economic benefits, as the following table shows, even where the materials cost is higher.7

 

 

ALLEVYN
Foam Dressing
Traditional
(Gauze) Dressing

Cost Per Change

Material cost per change:

$9.83

$6.36

Nurse cost per change:

$9.18

$9.18

Total cost per change:

$19.01

$15.54

X Frequency

Frequency of dressing change (per Week)

2

7

Cost Per Week

Material cost per week:

$19.66

$44.52

Nurse cost per week:

$18.36

$64.26

Total cost per week:

$38.02

$108.78

Savings

Material cost saving

$24.86

 

Nurse cost saving:

$45.90

Total cost saving with ALLEVYN:

$70.76


Smith & Nephew pioneered the development of low-change, foam dressings and associated protocols with its ALLEVYN range. Today, the ALLEVYN range has been developed with innovations for specific patient types, but its ability to manage exudate for up to 7 days without change is still a core clinical benefit.8

Cost of Healing

 

Reducing the Hidden Cost of Wound Care:
Infection Management

Infected wounds are a serious healthcare issue, causing greater levels of patient distress and anxiety, but also adding significantly to overall health care system costs.

In addition to the duty of care for the patient, systems have a strong economic imperative for taking pro-active steps to reduce the levels of hospital acquired infections, as shown in the follow table representing European data1:

Surgical infection affects 30-40 patients per 1,000 operations5

Mean additional length of stay = 11 days

Mean cost = €5,800 per case

Attributable mortality rate = 5%

EUROPEAN DATA

 

Based on this data, a hospital performing 10,000 operations annually can expect 300-400 infections, resulting in 3,300-4,400 extra bed days, producing €1.74m-€2.32m in additional costs and resulting in 15-20 deaths where infection can be attributed.

In-vitro studies have shown Smith & Nephew’s ACTICOAT to be a highly effective silver dressing, proven to kill over 150 pathogens in as little as 30 minutes.9

 

References

1 Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on healthcare providers in Europe. Journal of Wound Care, 2009; 18(4):154-161

2 Wild, S., Roglic, G., Green, A. et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. diabetes Care 2004; 27: 1047-1053.

3 Bales I, 2009. Reaching for the moon: achieving zero pressure ulcer prevalence. J Wound Care. 2009 Apr; 18(4):137-144

4 Reiber, G.E., Boyko, E.J., Smith, D.G. Lower extremity foot ulcers and amputations in diabetes. In: National Diabetes Data Group, National Institutes of Health. Diabetes in America (2nd edn). Us Government Printing Office (NIH pub. No. 95-1468), 1995.

5 Drew P, Posnett J, Rusling L, on behalf of the Wound Care Audit Team. The cost of wound care for a local population in England. Int Wound J 2007:4:149-155.

6 Lindholm, C., Bergsten, A., Berglund, E. Chronic wounds and nursing care. Journal of Wound Care 1999; 8: 1, 5-10.

7 Bale S, Squires D, Varnon T, Walker A, Benbow M, Harding KG. A comparison of two dressings in pressure sore management. J Wound Care 1997;6(10):463-466.

8 Payne W, Posnett J, Alvarez O, et al. A prospective, randomized clinical trial to assess the cost-effectiveness of a modern foam dressing versus traditional saline gauze dressing in the treatment of stage II pressure ulcers. Ostomy Wound Management 2009; 55(2):50-55

9 Smith & Nephew Data on file (DOF) (2007) reports showing in-vitro evidence of effectiveness against a broad range of wound pathogens; sustained antimicrobial activity up to 7 days; effective barrier against bacteria

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