What are the true System costs of wound care in the United States? One can find estimates for the costs of pressure ulcers. Diabetic wounds have an estimated cost to the system that’s been documented. All totaled it could be well over $200 billion. But less well publicized types of wounds like venous stasis ulcers and arterial wounds don’t have good data associated with their costs to the health care system. Trauma is a major category of cost to the system but the wounds associated with trauma have been lost within the data. Infection is well understood to drive costs of care and yet the wounds that harbor the infection are seldom considered. Would the infection have happened in the absence of the wound? In many cases no.
It is commonly understood that the five major contributors to cost in the health system are heart disease, cancer, trauma, mental disorders and pulmonary conditions. Diabetes is another condition frequently included in that conversation. But a compelling argument can be made that each of those conditions (even including mental disorders if restraint or low mobility leads to pressure ulcers) contains a component of costs attributable to wounds and wound care.
In today’s health care system, costs are examined by comparing data associated with the patient’s primary diagnosis. Wounds are coded as the primary diagnosis very infrequently but are very frequently the highest cost ancillary condition hiding behind the primary diagnosis.
In one specific case study performed by Advanced Healing Institute, the medical history for an 82 year old female with a history of diabetes and a previous amputation due to a diabetic wound was analyzed. Based on the coded information within the patient’s charts, Advanced Healing Institute was able to document the following items:
• Total cost of care for patients in this category can range from $20,000 to $200,000 or more depending on complications.
• The vast majority of those costs are attributable to wound care or subsequent infection of the wound.
• The patient had multiple physician visits and hospitalizations associated with the wound.
• An amputation was recommended for the patient's intact (wounded) limb during the treatment period but was prevented due to the fact that the TRUHEAL Wound Program was successful in healing the wound.
• Each provider and specialist type coded the primary diagnosis differently, even though the reason for the visit in all of the documented cases was the wound.
What if wounds and wound care account for 10% of total health care costs in the United States? What if it’s greater than ten percent? Would we do anything differently if we could document that wounds are the second leading cause for hospital readmissions? Is it time yet dig deeper into the costs and outcomes of wounds and wound care in our health system?
Advanced Health Institute has developed tools and methodologies that can begin to peel back the onion or the layers of data that obscure the costs of wounds and wound care to the system, but until the system recognizes the risk it cannot begin to quantify the opportunity for cost reduction and far more importantly for improved wound healing outcomes.