The financial and quality‐of‐life cost to patients living with a chronic wound in the community

Abstract

Chronic wounds are associated with financial and personal costs. The system level expense associated with chronic wounds has been established, however, the out-of-pocket cost incurred by individuals who self-fund has not been the focus of extensive investigation. Recently, there has been renewed interest in evaluating quality of life, in line with the shift to patient enablement and self-care in chronic disease management. The objectives of this research were to describe the out-of-pocket wound treatment costs and the quality of life of people who have chronic wounds. A questionnaire incorporating the Cardiff Wound Impact Schedule and purpose-designed instruments was completed by a non-probability, convenience sample of 113 people in Australia and Wales. Data was analysed using descriptive statistics. The sample was on average 63·6 years of age and had wounds that were on an average 109 weeks duration. Participants had spent on average AU$2475 on wound dressing products since the wound started, and AU$121·82 in the most recent 28 days which represented 10% of their disposable income. Health-related quality of life was sub-optimal, 6/10 (ave) according to the Cardiff Wound Impact Schedule. Younger participants reported significantly poorer quality of life on all CWIS sub-scales when compared to older participants. This study found that chronic wounds present a significant financial cost to individuals who must self-fund their wound dressings and other wound treatment related expenses. Participants who had access to wound product subsidisation also experienced personal financial costs. People who have chronic wounds experience sub-optimal quality of life therefore this condition is also costly to the individual's well-being. The quality of life of younger people has not received adequate attention and requires further consideration given the many years that younger people may have to live with this debilitating and often recurrent condition. Continued action is required to reduce the financial and personal costs experienced by people who have chronic wounds. It is imperative that healthcare funding is directed to people who have chronic wounds, in particular to alleviate the out-of-pocket costs experienced by self-funders. Continued attention to the quality of life of people who have chronic wounds is required to minimise the negative effects of this condition and enhance well-being.

Measuring costs and quality of life for venous leg ulcers

“…26 This study found that participants spent AU $2475.00 (2017 dollars), on average, on wound dressing products since the wound started (with an average wound duration of 109 weeks). 26 It also reported that people spent AU$121.82 on their wound in the most recent 28 days, which represented 10% of their disposable income. 26 Although this study was not specific to VLUs, it supports our finding that the cost of wound care is significant.…”

“…A third study measured costs for people living in the community, in Australia and Wales, with chronic wounds generally . This study found that participants spent AU$2475.00 (2017 dollars), on average, on wound dressing products since the wound started (with an average wound duration of 109 weeks) . It also reported that people spent AU$121.82 on their wound in the most recent 28 days, which represented 10% of their disposable income .…”

“…26 It also reported that people spent AU$121.82 on their wound in the most recent 28 days, which represented 10% of their disposable income. 26 Although this study was not specific to VLUs, it supports our finding that the cost of wound care is significant.…”

How and why patients self‐treat chronic wounds

“…Participants reported a high level of self-efficacy (33⋅9/40) and moderate level of perceived social support (68/100) (Refer Tables 1 and 2). Further information about the characteristics of the sample, out-of-pocket wound treatment costs and quality of life has been previously reported (4). Results for the sample of 100 participants have been reported, unless otherwise specified.…”

“…Self‐treatment of chronic wounds involves wound cleansing, wound inspection, applying and removing wound dressings and/or applying and removing other therapies such as compression bandaging . How and why individuals self‐treat chronic wounds has not been systematically investigated, although this practice has been noted as preferable and acceptable in case study research and is reported to occur among individuals who have malignant wounds .…”