The ‘hidden epidemic’ of chronic wounds

4 minute read

A new report reveals the billions of dollars they cost to manage each year in Australia.

Chronic wounds are costing patients an average of $4000 in out-of-pocket costs every year and the AMA wants a major injection of funding from the federal government to address the crisis.

Coinciding with Wound Awareness Week, the AMA has released a new report detailing how the heavy cost of medical dressings and treating chronic wounds could be mitigated through targeted investment which would save the health system $203.4 million over the next four years.

AMA vice-president Dr Danielle McMullen said the AMA’s analysis showed investing $23.4 million over four years to deliver best practice wound care for diabetic foot ulcers, arterial leg ulcers, and venous leg ulcers would save the health system $203.4 million.

“This is a no-brainer for a government desperate to cut the deficit. I don’t know of many investments where for every $1 you spend, the return is $8.36, but this is the case with evidence-based wound care,” she said.

The Solutions to the Chronic Wound Problem in Australia report reveals chronic wound care is a poorly understood and under-funded public health issue, despite studies indicating chronic wounds affect 450,000 Australians and cost $3 billion each year.

The AMA is calling on the government to provide more support for GPs through a national scheme to fund medical dressings for chronic wounds and extra Medicare funding to cover the unmet costs of providing care for patients suffering chronic wounds.

AMA modelling shows chronic wounds treated in hospitals place an additional burden on an already stretched system and resulted in close to 32,000 hospital admissions in 2019-20 costing $352 million and 249,346 patient days.

The report provides costed solutions to improve wound management in general practice and estimated savings associated with the proposed MBS items.

Dr McMullen said the plan would also improve access to GPs, with research showing additional Medicare funding for wound care would free up around 148,000 general practitioner consultations in the first year, and 162,000 consultations by the fourth year, making an enormous difference to patients.

“As GPs, we see some terrible consequences for patients if a wound isn’t managed properly, like amputations at the worst and nasty infections at least,” she said.

“They can take months or even years to heal and these are totally avoidable. At the moment Medicare doesn’t cover the cost of the dressings we need to treat chronic wounds correctly, so doctors are either bearing the costs themselves or are forced to pass on the cost to patients, and that’s not something we like doing.”

She said there was a lack of awareness about the significance of chronic wounds in Australia, which meant vulnerable patients, mostly older Australians, Aboriginal and Torres Strait Islander peoples, or patients with other chronic conditions, “often suffer in silence and fall through the cracks in our health system.”

“The government often mentions its inherited trillion-dollar debt, so it should be looking for smart investments which will save the health system money and deliver better health outcomes for patients at the same time,” Dr McMullen said.

Burns specialist and former Australian of the year Professor Fiona Wood described chronic wounds as “Australia’s hidden epidemic” and said the average patient faced $4000 in out-of-pocket costs every year.

“That’s around $340 every month,” she said. “The costs of chronic wounds are not covered by Medicare. This means patients are forced to choose between treatment and their everyday bills.

Wounds Australia chair Hayley Ryan said “sensible and straightforward steps to support federal funding for wound care and a public awareness campaign can slash the burden of chronic on our health and aged care systems”.

The peak body has its own 11 Point Plan spearheaded by the development of what it calls a National Wounds Framework.

“Our solutions are based on the expertise of health and aged care professionals, patients and at-risk groups, and specialists in Australia’s health and aged care systems,” Ms Ryan said.

“The solutions we have detailed in the following pages must be regarded as a priority for our nation’s health and aged care sectors. Without urgently addressing wound treatment, Australia’s hidden epidemic will continue to escalate and burden the physical and emotional health of the country, while draining billions of dollars away from other vital priorities.”

Melbourne dermatologist Professor Rodney Sinclair said wound management was a big problem in Australia, and not just for GPs.

He revealed chronic wound care had once been a major component of dermatologists’ workload, but that many had walked away from providing the services because of the huge costs involved.

“The cost for the clinic in terms of providing dressings and dressing changes is so high that you can’t recover that. You end up going backwards very quickly,” he said.

“So people are passed over to nursing specialists and they just have huge out-of-pocket costs. Something needs to be done.”

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