Inpatient Expenditure Composition and Factors Associated with High-Expenditure Patients with Chronic Wounds: A...

Background: Chronic wounds impose a substantial clinical and economic burden on patients and health systems. The purpose of this study was to characterize the composition and concentration of inpatient expenditure among patients with chronic wounds, identify clinical and treatment-related factors associated with higher inpatient expenditure, and describe the characteristics and expenditure contribution of high-expenditure patients. Methods: This single-center retrospective study included 713 patients discharged after inpatient treatment for chronic wounds at a tertiary hospital in the Inner Mongolia Autonomous Region, China, between 2020 and 2024. Demographic characteristics, comorbidities, infection status, wound pathogen results, treatment procedures, clinical outcomes, length of stay, and inpatient expenditure were collected. Patients in the top 10% of total inpatient expenditure were defined as high-expenditure patients. Descriptive analyses, expenditure stratification, multivariable regression, and expenditure concentration analyses were performed. Results: Medical consumables, diagnostic services, treatment procedures, and medications were the main components of inpatient expenditure. Length of stay, peripheral arterial disease, clinical infection, cardiovascular disease, comorbidity burden, wound pathogen results, and surgical interventions were associated with higher inpatient expenditure. High-expenditure patients represented a small proportion of the cohort but accounted for approximately one-third of total inpatient expenditure and had greater clinical complexity, including higher prevalence of infection and vascular disease and more intensive treatment needs. Conclusions: Inpatient chronic wound care is characterized by substantial expenditure, complex clinical management, and concentration of resource use among a small high-expenditure subgroup. Early risk identification, multidisciplinary management, standardized treatment pathways, and targeted resource-allocation strategies may help improve the efficiency of chronic wound care.