A preventative policy is in chronic need

Experts call for the government to fund a preventative approach to wound management.

A preventative approach to wound management would reduce the massive cost burden on the Australian healthcare system. But first, money has to be spent.

This is according to wound care experts who gathered at the Australian Wound Management Association National Conference last month.

“If we can convince the government that by spending money in a certain way that will save a lot more money in the long run, we are probably able to influence policy,” said Associate Professor Bill McGuiness, AWMA’s new president.

It has been reported to cost the Australian healthcare system $2.6 billion dollars and is the second most billed Medicare item by GPs, yet chronic wounds are still causing vast numbers of unnecessary amputations and destroying quality of life.

“Chronic wounds affect more than 270,000 people. They are the silent majority – elderly people from the generation that don’t complain and are happy with what they can get,” McGuiness said.

“We are still battling to get our patients what they need. As well as being costly to the healthcare system, it’s also expensive for the patient with the elderly paying more than $100 for products to treat wounds. These need to be subsidised.”

Efficient analysis of the potential risk of a patient developing chronic wounds is an essential measure in prevention, said Dr Barbara Braden, a US wound management expert.

Inventor of the Braden Scale, used to predict pressure ulcer risk, Braden said US policymakers moved to increase screening for risk factors once it identified the large costs that treating chronic wounds was costing the health system.

“Once they realised the cost to Medicare was so high, it was identified that most pressure ulcers are preventable if the right steps are followed.”

In 2007, $12 billion was spent in US on treating 257,412 cases of pressure ulcer wounds in hospitals at an average additional cost of $43,180 per patient. In almost all cases pressure ulcers can be avoided, yet developing a pressure ulcer after admission can double the length of a patient’s stay in hospital.

Policy changes meaning hospitals having to pay for the cost of treatment to wounds developed during a stay and an increase in rates of litigation from personal injury claims has led to the introduction of risk assessment programs in the US.

Simple screening measures using internationally standardised processes such as the Braden Scale can dramatically reduce the instances of pressure ulcers and reduce costs in treatment while also delivering better patient outcomes, Braden said.

McGuiness also wants to see a national database on chronic wounds developed.

“We need a minimum data set that we’re prepared to collect so we know what the wounds are,” he said.

The Australian Wound Management Association has an online petition asking the government for urgent attention to the problem of chronic wounds. Go to www.elephantintheroom.com.au.

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