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Current home care expenditures for persons with leg ulcers
Elaine H Friedberg1, Margaret B Harrison, Ian D Graham
1Continuity of Care Program, Clinical Epidemiology Unit, Ottawa Health Research Institute, Civic Campus, Ottawa Hospital, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9 Canada. efriedberg@ohrl.ca
Summary
Home care for leg ulcers costs millions annually. Reducing travel time and visit frequency can significantly lower expenditures for this patient population.
Area of Science:
- Health Economics
- Nursing Research
- Wound Care Management
Background:
- Leg ulcers represent a significant health burden, requiring extensive home care services.
- Understanding the financial implications of home care for leg ulcer patients is crucial for resource allocation.
Purpose of the Study:
- To determine the home care expenditures associated with managing patients who have leg ulcers.
- To identify key cost drivers in leg ulcer home care.
Main Methods:
- A descriptive survey was conducted over four weeks in an urban Ontario center.
- Data were collected using researcher-developed tools, including a leg assessment tool, supply usage form, and visiting nurses log.
- Home care nurses conducted in-depth client assessments, including leg inspections, ankle-brachial pressure index (ABPI) measurements, and ulcer evaluations, while tracking supply usage, travel, and treatment times.
Main Results:
- A total of 2270 nursing visits were made, with an average treatment time of 26 minutes and travel time of 17 minutes per visit.
- The average cost per visit was $80.62 (Canadian dollars), with supply costs averaging $21.06.
- Regional annual home care expenditures for leg ulcers were estimated at a minimum of $1.3 million.
Conclusions:
- Significant potential exists for cost reduction in leg ulcer home care.
- Strategies include minimizing travel time (currently 40% of visit time), adjusting visit frequency for clients with minimal drainage, and adhering to best practices in wound management.