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]
