Guest JF, Ayoub N, McIlwraith T, Uchegbu I, Gerrish A, Weidlich D, Vowden K, Vowden P, et al.
BMJ open. Date of publication 2015 Dec 7;volume 5(12):e009283.
1. BMJ Open. 2015 Dec 7;5(12):e009283. doi: 10.1136/bmjopen-2015-009283.
Health economic burden that wounds impose on the National Health Service in the
UK.
Guest JF(1), Ayoub N(2), McIlwraith T(2), Uchegbu I(2), Gerrish A(2), Weidlich
D(2), Vowden K(3), Vowden P(3).
Author information:
(1)Catalyst Health Economics Consultants, Northwood, Middlesex, UK Faculty of
Life Sciences and Medicine, King's College, London, UK.
(2)Catalyst Health Economics Consultants, Northwood, Middlesex, UK.
(3)Bradford Teaching Hospitals NHS Foundation Trust and University of Bradford,
Bradford, UK.
OBJECTIVE: To estimate the prevalence of wounds managed by the UK's National
Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource
use attributable to their management and corresponding costs.
METHODS: This was a retrospective cohort analysis of the records of patients in
The Health Improvement Network (THIN) Database. Records of 1000 adult patients
who had a wound in 2012/2013 (cases) were randomly selected and matched with 1000
patients with no history of a wound (controls). Patients' characteristics,
wound-related health outcomes and all healthcare resource use were quantified and
the total NHS cost of patient management was estimated at 2013/2014 prices.
RESULTS: Patients' mean age was 69.0 years and 45% were male. 76% of patients
presented with a new wound in the study year and 61% of wounds healed during the
study year. Nutritional deficiency (OR 0.53; p<0.001) and diabetes (OR 0.65;
p<0.001) were independent risk factors for non-healing. There were an estimated
2.2 million wounds managed by the NHS in 2012/2013. Annual levels of resource use
attributable to managing these wounds and associated comorbidities included 18.6
million practice nurse visits, 10.9 million community nurse visits, 7.7 million
GP visits and 3.4 million hospital outpatient visits. The annual NHS cost of
managing these wounds and associated comorbidities was £5.3 billion. This was
reduced to between £5.1 and £4.5 billion after adjusting for comorbidities.
CONCLUSIONS: Real world evidence highlights wound management is predominantly a
nurse-led discipline. Approximately 30% of wounds lacked a differential
diagnosis, indicative of practical difficulties experienced by non-specialist
clinicians. Wounds impose a substantial health economic burden on the UK's NHS,
comparable to that of managing obesity (£5.0 billion). Clinical and economic
benefits could accrue from improved systems of care and an increased awareness of
the impact that wounds impose on patients and the NHS.
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DOI: 10.1136/bmjopen-2015-009283
PMCID: PMC4679939
PMID: 26644123 [Indexed for MEDLINE]
