Wound Care Outcomes and Associated Cost Among Patients Treated in US Outpatient Wound Centers

Data From the US Wound Registry

Caroline E. Fife, MD, CWS; Marissa J. Carter, PhD, MA; David Walker, CHT; Brett Thomson, BS

Disclosures

Wounds. 2012;24(1) 

In This Article

Conclusion

Although the authors recognize the limitations of this project, several statements may be made about wound "outcomes" among outpatients in the United States:Patients with chronic wounds frequently have serious comorbid conditions that distinguish them from the subjects of wound care RCTs.

  1. Despite these comorbid conditions, nearly two-thirds of patients seen at hospital based outpatient wound centers heal their wounds. A healing rate of 66% may be a realistic estimation of "healing rates" in these compromised patients.

  2. Nearly one third of patients in hospital based outpatient wound centers may not heal their wounds even though they are cared for over a long period of time (outcomes include amputation, death, and uncertain).

  3. Several factors can be defined that increase the duration and cost of wound care, including wound etiology, as well as several specific patient factors. These patient factors likely impact the effectiveness of advanced therapeutics in ways which cannot be ascertained by RCTs.

  4. The longer patients with nonhealing wounds continue to be seen in the outpatient wound center, the greater their cost of care. (These expenditures may prevent hospitalization or other complications, but further research is needed to explore these hypotheses).

The authors believe that this registry demonstrates that outcome information can be a byproduct of documenting care with EHRs, as promoted by the IOM. This Wound Registry would seem to offer ideal opportunities for comparative effectiveness research in wound care, since it includes typical patients often excluded from RCTs, and reflects actual practice.

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