Reducing Costs By Preventing Amputations Through Specialized Wound Care
Diabetes can ravage the body in many ways. The most common outward complications of the disease are open ulcers and wounds on the feet and lower legs. These afflictions and related complications can often lead to lower extremity amputation (LEA). In fact, diabetes is the leading non-traumatic cause of lower extremity amputation (LEA) in the United States. It is estimated that every 30 seconds a lower limb is amputated because of a diabetic wound.
In the United States, individuals with diabetes have about three-and-a-half times more frequent hospital admissions than those without the disease, and account for $171 billion in hospital charges, about 22% of the total. Although the U.S. is home to an estimated 26 million diabetics, the cost of caring for someone with diabetes accounts for $1 out of every $5 spent on health care.
The costs for patients with infected ulcers or peripheral arterial disease is staggering at nearly $21,000. Even minor amputations, such as removing a big toe, cost an average of $23,000. If a wound progresses to the point where lower-extremity amputation is required, the initial cost is approximately $65,000, but the lifetime cost of caring for the patient can exceed half a million dollars.
As overwhelming as these figures are, the actual healthcare dollars spent underestimates the true cost by not including the loss of productivity by these patients. The emotional impact and overall human costs must also be considered: amputation not only significantly reduces a patient's quality of life, but it also can mean loss of life itself. Studies show that three in five diabetics die within five years of their amputations.
A specialized approach to wound care can prevent amputations and reduce many of these costs, while also improving the health of the patient. Although many physicians routinely treat acute wounds in their day-to-day practice, chronic wounds of the lower extremities present a particular challenge. As with any chronic disease process, a wound that has been treated unsuccessfully and may lead to an amputation requires comprehensive intervention by multiple disciplines and experts to address the many conditions and comorbidities that impact wound healing.
Many lower extremity amputations may be prevented through a specialized, and comprehensive approach to treatment involving a variety of therapies and techniques. These therapies and techniques include debridement, dressing selection, hyperbaric oxygen therapy (HBOT), and many other adjuvant therapies. Diversified Clinical Services, Inc. (DCS), Â the largest and most established wound care management company with more than 325 hospital partners, reported an 89% heal rate within 31 median days-to-heal in 2010. A key reason for this high success rate is due to the use of HBOT, a treatment that has been used to assist wound healing for more than 40 years and is reimbursed for certain conditions by Medicare and most insurers.
"The healing and future prevention of chronic wounds requires an interdisciplinary approach," explains Dr. Robert Warriner III, Diversified Clinical Services' chief medical officer and recipient of The World Union of Wound Healing Society's Lifetime Achievement Award. "It is not unusual for our Wound Care Center® patients to come in for the first time after suffering from a wound for one, five, or even 15 years. A wound that heals in 31 days versus five years or more is considerably less costly to society and the patient." In 2010 alone, DCS Wound Care Centers effectively provided more than 218,000 HBOT treatments. HBOT involves the systemic delivery of oxygen through pressurized chambers. Best known as an antidote for the "bends" (decompression illness), HBOT is also a proven method to advance wound healing.
Essentially, HBOT helps heal the wound from the inside out. By super-oxygenating the wounds, HBOT can help reduce swelling, help fight infection and encourage growth of new blood vessels, and ultimately produce healthier tissue. In one study, 94% of patients receiving systemic HBOT maintained an intact limb 55 months after therapy.
During HBOT, patients are monitored for the increased concentration of oxygen in the blood near the wound. If the oxygen level is higher, the therapy is most likely beneficial to the patient.
HBOT is an approved and accepted adjunctive therapy for diabetic wounds, Wagner Grade 3 or higher in severity. Medicare and many other payers approve it. A typical course of treatment involves the patient spending about 90 minutes per day in the chamber, five days per week, over a four-to-six-week period. The average cost for using HBOT to heal a diabetic wound is estimated to be less than $20,000.
Certainly, as we try to spend health dollars more wisely, ever-increasing attention will be given to measuring and comparing the clinical and cost effectiveness of therapies. When judging chronic wound treatment, however, we must recognize that the alternative is most likely amputation. A specialized approach to chronic wound care that may include advanced therapies such as HBOT, is not only safe and effective for the patient, but also cost-effective for payers.
© 2011 Diversified Clinical Services, Inc.
All Rights Reserved.
In the United States, individuals with diabetes have about three-and-a-half times more frequent hospital admissions than those without the disease, and account for $171 billion in hospital charges, about 22% of the total. Although the U.S. is home to an estimated 26 million diabetics, the cost of caring for someone with diabetes accounts for $1 out of every $5 spent on health care.
The costs for patients with infected ulcers or peripheral arterial disease is staggering at nearly $21,000. Even minor amputations, such as removing a big toe, cost an average of $23,000. If a wound progresses to the point where lower-extremity amputation is required, the initial cost is approximately $65,000, but the lifetime cost of caring for the patient can exceed half a million dollars.
As overwhelming as these figures are, the actual healthcare dollars spent underestimates the true cost by not including the loss of productivity by these patients. The emotional impact and overall human costs must also be considered: amputation not only significantly reduces a patient's quality of life, but it also can mean loss of life itself. Studies show that three in five diabetics die within five years of their amputations.
A specialized approach to wound care can prevent amputations and reduce many of these costs, while also improving the health of the patient. Although many physicians routinely treat acute wounds in their day-to-day practice, chronic wounds of the lower extremities present a particular challenge. As with any chronic disease process, a wound that has been treated unsuccessfully and may lead to an amputation requires comprehensive intervention by multiple disciplines and experts to address the many conditions and comorbidities that impact wound healing.
Many lower extremity amputations may be prevented through a specialized, and comprehensive approach to treatment involving a variety of therapies and techniques. These therapies and techniques include debridement, dressing selection, hyperbaric oxygen therapy (HBOT), and many other adjuvant therapies. Diversified Clinical Services, Inc. (DCS), Â the largest and most established wound care management company with more than 325 hospital partners, reported an 89% heal rate within 31 median days-to-heal in 2010. A key reason for this high success rate is due to the use of HBOT, a treatment that has been used to assist wound healing for more than 40 years and is reimbursed for certain conditions by Medicare and most insurers.
"The healing and future prevention of chronic wounds requires an interdisciplinary approach," explains Dr. Robert Warriner III, Diversified Clinical Services' chief medical officer and recipient of The World Union of Wound Healing Society's Lifetime Achievement Award. "It is not unusual for our Wound Care Center® patients to come in for the first time after suffering from a wound for one, five, or even 15 years. A wound that heals in 31 days versus five years or more is considerably less costly to society and the patient." In 2010 alone, DCS Wound Care Centers effectively provided more than 218,000 HBOT treatments. HBOT involves the systemic delivery of oxygen through pressurized chambers. Best known as an antidote for the "bends" (decompression illness), HBOT is also a proven method to advance wound healing.
Essentially, HBOT helps heal the wound from the inside out. By super-oxygenating the wounds, HBOT can help reduce swelling, help fight infection and encourage growth of new blood vessels, and ultimately produce healthier tissue. In one study, 94% of patients receiving systemic HBOT maintained an intact limb 55 months after therapy.
During HBOT, patients are monitored for the increased concentration of oxygen in the blood near the wound. If the oxygen level is higher, the therapy is most likely beneficial to the patient.
HBOT is an approved and accepted adjunctive therapy for diabetic wounds, Wagner Grade 3 or higher in severity. Medicare and many other payers approve it. A typical course of treatment involves the patient spending about 90 minutes per day in the chamber, five days per week, over a four-to-six-week period. The average cost for using HBOT to heal a diabetic wound is estimated to be less than $20,000.
Certainly, as we try to spend health dollars more wisely, ever-increasing attention will be given to measuring and comparing the clinical and cost effectiveness of therapies. When judging chronic wound treatment, however, we must recognize that the alternative is most likely amputation. A specialized approach to chronic wound care that may include advanced therapies such as HBOT, is not only safe and effective for the patient, but also cost-effective for payers.
© 2011 Diversified Clinical Services, Inc.
All Rights Reserved.
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