Comparison of Healthcare Costs Associated With Patients Receiving Traditional Negative Pressure Wound Therapies in the Post-Acute Setting.

Amy L Law,Leah Griffin,Bhavana Karnik,Blake Krebs

doi:10.7759/cureus.11790

Abstract

ObjectiveA retrospective national insurance claims database analysis evaluated total and wound-related costs for acute and chronic wound patients treated with negative pressure wound therapy (NPWT), comparing a product specific NPWT (NPWT-K) to other NPWT systems (NPWT-O).MethodsPatients with one or more NPWT claims between January 2016 and September 2018 in an outpatient setting with continuous medical and pharmacy benefits for six months before the initial (index) NPWT claims and 12 months post index were assessed. The cohorts were propensity score matched based on age, gender, comorbidities, and payer type. Each cohort included 3,368 patients after matching. Costs were evaluated at 30 days, three months, and 12 months after initial NPWT placement. Hospital admission rates, emergency room (ER) visits, and NPWT device switching were evaluated at 30 days. Differences were analyzed by t-test and chi-square test.ResultsAt 30 days, wound-related costs were $8,583 and $11,334, and total cost to treat was $17,809 and $24,405 for NPWT-K and NPWT-O, respectively (p < 0.0001). NPWT-O patients had higher NPWT, wound-related, and total costs across all time periods, as well as a longer average length of therapy (p = .0039). There was no statistical difference in 30-day hospital admissions (p = 0.089); although 30-day ER visits were higher for NPWT-K (4.9% vs. 3.3%, p = 0.0007). A higher degree of switching from NPWT-O to NPWT-K occurred at 30 days (NPWT-O 2.5% vs. 0.4%, p < 0.0001).ConclusionsThis comparative effectiveness analysis indicates differences remain across NPWT suppliers in wound-related and total cost to treat for patients who receive durable NPWT in the outpatient setting.

Highlights

There is a growing understanding that wound care, hard to monetize, is costly
There was no statistical difference in 30-day hospital admissions (p = 0.089); 30-day emergency room (ER) visits were higher for negative pressure wound therapy (NPWT)-K (4.9% vs. 3.3%, p = 0.0007)
A higher degree of switching from NPWT-O to NPWT-K occurred at 30 days (NPWT-O 2.5% vs. 0.4%, p < 0.0001)

Summary

Introduction

There is a growing understanding that wound care, hard to monetize, is costly. Health expenditures in wound care have been estimated between $28.1 billion and $96.8 billion for the Medicare population alone. A national estimate of wound care would significantly exceed these expenditures [1]. 15% of Medicare beneficiaries have at least one type of wound or wound-related infection, with care largely occurring in the outpatient setting [1]. Treatment of these patients, who often have multiple comorbidities that impede wound healing, is a multi-disciplinary effort. Cross-collaboration between providers and suppliers across care settings can help improve the quality and effectiveness of care and benefit both the patients and the payers

Methods

Results

Conclusion