Digitising wound care: a cost-consequence analysis of the Wound Care Command Centre™ in Australia

Chronic wounds pose considerable financial challenges for healthcare systems globally, with most cases requiring hospital care and extended lengths of stay, particularly due to delayed access to treatment. To address this, Sydney Local Health District (LHD) in Australia launched the Wound Care Command Centre™ in 2023, utilising a digital application for timely access to wound care and to reduce the burden on hospitals. This study evaluates the cost consequences of this Centre by comparing healthcare service use under this new model of care compared to service use under standard clinical practice after one year of operation to determine savings to the health system.

Admitted patient, non-admitted and emergency department patient records relating to chronic wounds between 2018 and 2024 were analysed to determine service use costs, number of chronic wound admissions, length of stay, non-admitted services and emergency department presentations. Regression was used to control for patient mix, and records from a neighbouring LHD utilising the standard clinical care model was used as a control for this study.

We estimated that with the Wound Care Command Centre™, in 2023 there were up to 97 chronic wound admissions prevented, 943 hospital days averted due to earlier discharges, 308 more non-admitted service events and 208 more emergency department presentations in Sydney LHD, compared to expected levels under standard clinical practice models. This was consistent with reduced prevalence of complex cellulitis admissions in Sydney LHD and partial shifting of care from admitted to outpatient settings. Reduced hospital admissions and earlier discharges were estimated to total between $3.2 M to $4.8 M and costs of non-admitted and emergency department services were estimated to total $264k. After accounting for $1.3 M operational costs for the Command Centre over 2023, net savings were between $1.7 M to $3.3 M.

The Wound Care Command Centre™ reduced hospital admissions by 97 individuals and shortened hospital length of stays by 1.1 day, resulting in savings up to $3.3 M for Sydney LHD. Additional benefits for patients included increased access to specialist advice through the and reduced face-to-face contact due to use of a digital platforms minimising unnecessary hospital visits for patients.