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Nussbaum SR, Carter MJ, Fife CE, DaVanzo J, Haught R, Nusgart M, Cartwright D, et al.
Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes R.... Date of publication 2018 Jan 1;volume 21(1):27-32.
1. Value Health. 2018 Jan;21(1):27-32. doi: 10.1016/j.jval.2017.07.007. Epub 2017 Sep 19. An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds. Nussbaum SR(1), Carter MJ(2), Fife CE(3), DaVanzo J(4), Haught R(4), Nusgart M(5), Cartwright D(6). Author information: (1)Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA. (2)Strategic Solutions, Inc., Cody, WY, USA. (3)Baylor College of Medicine, Houston, TX, USA; CHI St. Lukes Hospital, The Woodlands, TX, USA; The US Wound Registry, The Woodlands, TX, USA. (4)Dobson/DaVanzo & Associates LLC, Vienna, VA, USA. (5)Alliance of Wound Care Stakeholders, Bethesda, MD, USA. Electronic address: marcia@woundcarestakeholders.org. (6)Integra Lifesciences, Plainsboro, NJ, USA. OBJECTIVE: The aim of this study was to determine the cost of chronic wound care for Medicare beneficiaries in aggregate, by wound type and by setting. METHODS: This retrospective analysis of the Medicare 5% Limited Data Set for calendar year 2014 included beneficiaries who experienced episodes of care for one or more of the following: arterial ulcers, chronic ulcers, diabetic foot ulcers, diabetic infections, pressure ulcers, skin disorders, skin infections, surgical wounds, surgical infections, traumatic wounds, venous ulcers, or venous infections. The main outcomes were the prevalence of each wound type, Medicare expenditure for each wound type and aggregate, and expenditure by type of service. RESULTS: Nearly 15% of Medicare beneficiaries (8.2 million) had at least one type of wound or infection (not pneumonia). Surgical infections were the largest prevalence category (4.0%), followed by diabetic infections (3.4%). Total Medicare spending estimates for all wound types ranged from $28.1 to $96.8 billion. Including infection costs, the most expensive estimates were for surgical wounds ($11.7, $13.1, and $38.3 billion), followed by diabetic foot ulcers ($6.2, $6.9, and $18.7 billion,). The highest cost estimates in regard to site of service were for hospital outpatients ($9.9-$35.8 billion), followed by hospital inpatients ($5.0-$24.3 billion). CONCLUSIONS: Medicare expenditures related to wound care are far greater than previously recognized, with care occurring largely in outpatient settings. The data could be used to develop more appropriate quality measures and reimbursement models, which are needed for better health outcomes and smarter spending for this growing population. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jval.2017.07.007 PMID: 29304937 [Indexed for MEDLINE]
Appears in following Topics:
Quality in Wound Care
Arterial Ulcer - Introduction and Assessment
Principles of Wound Healing
Diabetic Foot Ulcer - Introduction and Assessment
Coding and Billing Essentials in Wound Care
June is Wound Healing Awareness Month