Outpatient care for venous leg ulceration in Germany: A retrospective claims data analysis

Outpatient care of venous leg ulcers (VLU) is a problem of high medical and health economic relevance. Treatment is often inconsistent and not guideline-compliant. The project Ulcus Cruris Care investigated the VLU outpatient care situation in Germany.

Reimbursement data of 40,046 patient cases (2015-2019) with VLU diagnosis from a statutory health insurer (AOK Baden-Wuerttemberg, Germany) were retrospectively analyzed. Outcome assessment was based on prescriptions, medical aids, nursing care, use of compression devices, surgical procedures and treatment costs.

47.3% (n  =  7,581) of patients without contraindication received a compression device within 90 days. 2.3% (n  =  135) received surgical truncal vein interventions. 14.1% (n  =  771) received consistent compression therapy associated with faster wound healing (121.6 ± 86.2 vs. 188.1 ± 164.2 days, p < 0.001), lower total costs (4,280 ± 5,326 € vs. 5,683 ± 9,657 €, p < 0.001) and lower disease-specific costs (2,498 ± 2,785 € vs. 2,797 ± 5,145 €, p  =  0.017) versus no or unsteady treatment.

In outpatient VLU care around 80% of patients do not receive consistent compression therapy and are therefore not adequately treated. There is an urgent need for action to improve treatment of patients with VLU in Germany.