Woundcare spending

How much do we spend on wound care in relative and absolute terms is a hard question to answer. Luckily we have some information thanks to the Welsh NHS system which provides some data.

The article in the total cost of managing patients with chronic wounds in Wales amounted to £328·8 million – an average cost of £1727 per patient and 5·5% of total expenditure on the health service in Wales.  With a prevalence of 6%. Not too far away from the Welsh expenses on Cancer. The figures for 2012-13 show the total spend has increased from £356.8m in 2011-12 to £360.9m in 2012-13.

So there you have it!

Wound care is expensive, it equals the cancer expenses (90%). Wound care costs were generally believed to be somewhere between 1,5-4% on any healthcare budget. This article adds the number 5.5%. If wounds were a disease it would be easily in the top five of any health care list. I am no specialist but I would bet these numbers are not that different for any EU country.  However, apparently it is not a disease because it rarely shows up on those lists.

First question to answer is: is this real? The answer is: we do not know. We have combined figures from very different sources, there may be logical errors in combining them. And wound care costs are varying from 1 to 5,5%… also not exactly strong data.  And then the question inevitably is: what costs are inside the data we compare?

But even if the data are questionable there are a few issues we should think about.: The sheer number of people literally suffering from wounds; not a few but a significant part of your population up to 6%. And even at low estimates the numbers demand attention.

So how are wounds looked at?
Insurers may see it as a cost disease (Baumol).
Most doctors see it as a complication instead of an indication.

Reality is, it is not a disease but an expensive complication where we, even though many suffer from it, know very little of. I would strongly advice to make it an indication, have a fresh look at the issue and start over. Research not progressing to the point where we have a strong underpinning is paradoxically a chance. I am happy to explain the intellectual challenges and opportunities this field has. Proper research will not magically shrink expenses or turn it into a disease, it will only justify why we spend so much on it. And hopefully bring the much needed attention.


Sources: Estimating the costs associated with the management of patients with chronic wounds using linked routine data – Phillips – 2015 – International Wound Journal – Wiley Online Library



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