Health Economics Study

Study to estimate the annual burden that wounds impose on the UK's National Health Service

The study objective is to estimate the total cost to the NHS of healthcare resource attributable to managing all wounds in a 12 month period. The remit of the study is limited to open external wounds and will not consider internal wounds.

The study is a retrospective cohort analysis of the records of patients in The Health Improvement Network (THIN) database (a nationally representative database containing anonymised longitudinal electronic medical records of >9 million patients registered with general practitioners (GPs) in the UK).

The study population will comprise a randomised sample of 1,000 patients who had a wound in their medical history between 1 May 2012 and 30 April 2013 (cases). These patients will be matched with an equivalent number of patients who did not have a wound (controls).

Wound care is a major part of the NHS spend

Information extracted from patients’ records will include age, gender, wound type, other symptoms and morbidities, and duration of wound. In addition, all healthcare resource use in the community and hospitals following the onset of the wound in the cases (or from the beginning of the study period if the wound occurred before 1 May 2012) will be extracted from patients' case notes and quantified. Healthcare resource use in the community and hospitals over the same period from a matched start date by the controls will also be extracted and quantified.

Using the aforementioned data set, a burden of illness model of wound care will be constructed. The model will be used to estimate the incremental amount of healthcare resource use attributable to managing wounds in a year. Resource use will be valued in monetary terms and using published epidemiological estimates, the model will be used to estimate:

  • The annual level of healthcare resource use attributable to managing all wounds within the NHS.
  • The annual NHS cost of healthcare resource attributable to managing all wounds.

The researchers have considerable experience in conducting health economic studies using longitudinal databases. These studies have resulted in numerous peer-reviewed publications. In one such study [1], using the THIN database and similar methodology the analysis examined the effect of malnutrition on clinical outcomes and healthcare resource use from initial diagnosis by GPs in the UK. The analysis found that the healthcare cost of managing malnourished patients was more than twice that of managing non-malnourished patients, due to increased use of healthcare resources. After adjusting for age and comorbidity, malnutrition remained an independent predictor of mortality.

In another study [2] the researchers used the THIN database to estimate the health outcomes and cost-effectiveness of using different superabsorbent dressings in the treatment of highly exuding chronic venous leg ulcers (VLUs) in the UK, from the perspective of the NHS. Information extracted from the database included patients' age, gender, wound duration, wound size, wound-related prescriptions for analgesics and antibiotics, wound healing rates, time to healing, dressing change frequency, healthcare resource use and corresponding costs of wound management. The analysis then ranked the different dressings in terms of their net monetary benefit to the NHS.

Find out more about the study at 

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 1. JF Guest, M Panca, J-P Baeyens, F de Man, O Ljungqvist, C Pichard, S Wait, L Wilson.Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK. Clinical Nutrition 2011; 30(4): 422-429.

 2. M Panca, K Cutting, JF Guest. Clinical and cost-effectiveness of absorbent dressings in the treatment of highly exuding VLUs. Journal of Wound Care 2013; 22(3): 109-118.




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