Q: What is the burden of wound care on the economy and society at large?

A: Developing a wound while a person is in a post-acute or long-term care setting carries a significant health and economic burden. Whether or not patients have wound risk factors, it is often assumed that wounds develop due to insufficient or negligent care.

Some wounds may be inevitable and unpreventable due to the risk factors of the patients. Quality markers may not differentiate. 

Most facilities shy away from accepting patients with wounds even if the wounds are secondary to venous stasis or arterial disease. This poses an excessive burden on families who are searching for a better and safer place for their loved ones.

In 2018, Samuel R. Nussbaum et al. published an article studying Medicare patients who developed and underwent treatment of acute or chronic wounds for any reason. They found that approximately 8.2 million residents/patients had wounds. The most common types were surgical and diabetic wounds, and total Medicare spending on wound care ranged from $28.1 billion to $96.8 billion. 

Although this study on economic burden may not be recent, the number of patients involved in wounds and the cost of care remains  eye-opening. We should be asking ourselves: What can be done at the state and federal levels to review acute and chronic wounds based on the person-centered quality matrix and reimbursements?

Do we consider patients’ pre-existing risk factors, presence of chronic conditions, mobility and post-surgical status before labeling a facility with sub-optimal quality indicators? The care of older adults with wounds is a subspeciality like neonatology or hand surgery. It is not just adult medicine.