Cost assesment of complex wound management in ambulatory care

Uvod: Zdravljenje kompleksnih ran sodi med pomembne probleme v javnem zdravstvu. Njihovo zdravljenje običajno poteka v daljšem časovnem obdobju in terja visoke materialne stroške. Uporaba sodobnih oblog znatno pripomore k izboljšanju celjenja ran, manjši prisotnosti bolečin ter zmanjšanju stroškov zdravljenja. V Sloveniji uvrščamo uporabo sodobnih oblog za oskrbo kompleksnih ran v redni program zdravljenja. Namen: V raziskavi smo želeli oceniti višino povprečnih materialnih stroškov, ki nastanejo pri ambulantnem zdravljenju kompleksnih ran. Metode: Izvedli smo opazovalno presečno raziskavo, v kateri smo beležili značilnosti ran ter vrsto in količino porabljenega materiala pri prevezah pri stotih naključno izbranih pacientih. Ocenili smo razpon in povprečne materialne stroške za oskrbo ran. Rezultati: Najpogostejše diagnoze pri pacientih, ki smo jih zajeli v raziskavi, so diabetično stopalo, arterijska razjeda in venska golenja razjeda. Rane večine pacientov so imele prisotne granulacije in fibrinske obloge. Največkrat uporabljene sodobne obloge za oskrbo ran so bile poliuretanske pene z dodatki. Razpon stroškov porabljenega materiala je med 2,67 in 42,4 evrov, povprečni stroški pa znašajo 13,41 evrov. Sklep: Pričujoča raziskava je prva opazovalna presečna raziskava ambulantnega zdravljenja kompleksnih ran pri nas, s katero smo želeli oceniti materialne stroške, ki nastanejo pri oskrbi ran, in predstavlja osnovo za nadaljnje raziskave na tem področju. V nadaljnjih raziskavah bi bilo treba analizirati več vrst stroškov in izvesti longitudinalne študije poteka zdravljenja kompleksnih ran.Introduction: The treatment of complex wounds is an important public health issue. Complex wounds are usually time consuming and costly to treat. The modern dressing application has a significant impact on improvement of wound healing rates, reduction of pain and cost of treatment. In Slovenia, complex wounds treatment cost using modern dressings is covered under the national health insurance. Purpose: The purpose of the study was the cost assessment of management of complex wounds in ambulatory care. Methods: We have conducted the cross-sectional observational study in which we have recorded characteristic of wounds and types and amount of material used for 100 randomly selected patients undergoing ambulatory treatment of complex wounds. The range and average costs of wound care were estimated. Results: The most common diagnosis in patients included in the study were diabetic foot ulcer, arterial ulcer and venous ulcer. In most cases granulation and wound fibrin were present. Modern dressings commonly used were polyurethane foams with additives. The costs of material used were estimated to range from 2,67 to 42,4 euros, while the average cost amounted to 13,41 euros. Discussion and conclusion: The present study is the first cross-sectional observational study for cost assessment of ambulatory treatment of complex wounds in Slovenia and provides a basis for further research in this area. Future studies might include analysis of more types of costs of ambulatory treatment of complex wounds and longitudinal study design