Medical costs of treating venous stasis ulcers: evidence from a retrospective cohort study - PubMed (original) (raw)
Medical costs of treating venous stasis ulcers: evidence from a retrospective cohort study
J W Olin et al. Vasc Med. 1999.
Abstract
Venous stasis ulcers (VSU) account for approximately 80-90% of lower extremity ulcerations. Given their prevalence and chronic nature, VSU are thought to impose a significant economic burden on Medicare (the USA's largest health insurance program) and other third party payers. However, comprehensive studies on the costs of VSU treatment are lacking. The objective of this study therefore was to examine comprehensively the direct medical costs of treating patients with a VSU in routine clinical practice. A cohort of 78 patients who presented with a VSU to the Cleveland Clinic Foundation (CCF), a large primary and tertiary referral center, was studied retrospectively. All inpatient and outpatient costs related to VSU treatment that were incurred during the year following VSU presentation or until the ulcer healed, whichever occurred first, were quantified. A total of 71 (91%) patients healed during the study. The average duration of follow-up was 119 days (median: 84 days). The average number of visits per patient was seven (range: 2 to 57). A total of 14 (18%) patients underwent 18 hospitalizations for VSU care. The average total medical cost per patient was 9685(median:9685 (median: 9685(median:3036). Home health care, hospitalizations and home dressing changes accounted for 48%, 25% and 21% of total costs, respectively. Total costs were related to duration of active therapy, ulcer size and the presence of at least one comorbidity (p<0.05). VSU are costly to manage, especially when time to healing is prolonged. The present findings reflect an underestimate of VSU costs since indirect costs were not examined. Time absent from work, forced early retirement, loss of functional independence and unquantifiable suffering may be additional factors that contribute to the overall burden of VSU.
Similar articles
- Endovenous laser ablation of great saphenous vein and perforator veins improves venous stasis ulcer healing.
Abdul-Haqq R, Almaroof B, Chen BL, Panneton JM, Parent FN. Abdul-Haqq R, et al. Ann Vasc Surg. 2013 Oct;27(7):932-9. doi: 10.1016/j.avsg.2012.09.014. Epub 2013 May 24. Ann Vasc Surg. 2013. PMID: 23711972 - Outcome of venous stasis ulceration when complicated by arterial occlusive disease.
Bohannon WT, McLafferty RB, Chaney ST, Mattos MA, Gruneiro LA, Ramsey DE, Hodgson KJ. Bohannon WT, et al. Eur J Vasc Endovasc Surg. 2002 Sep;24(3):249-54. doi: 10.1053/ejvs.2002.1650. Eur J Vasc Endovasc Surg. 2002. PMID: 12217288 - The real cost of treating venous ulcers in a contemporary vascular practice.
Ma H, O'Donnell TF Jr, Rosen NA, Iafrati MD. Ma H, et al. J Vasc Surg Venous Lymphat Disord. 2014 Oct;2(4):355-61. doi: 10.1016/j.jvsv.2014.04.006. Epub 2014 Jun 24. J Vasc Surg Venous Lymphat Disord. 2014. PMID: 26993537 - Annual costs of treatment for venous leg ulcers in Sweden and the United Kingdom.
Ragnarson Tennvall G, Hjelmgren J. Ragnarson Tennvall G, et al. Wound Repair Regen. 2005 Jan-Feb;13(1):13-8. doi: 10.1111/j.1067-1927.2005.130103.x. Wound Repair Regen. 2005. PMID: 15659032 - Topical Sevoflurane: A Novel Treatment for Chronic Pain Caused by Venous Stasis Ulcers.
Aranke M, Pham CT, Yilmaz M, Wang JK, Orhurhu V, An D, Cornett EM, Kaye AD, Ngo AL, Imani F, Farahmand Rad R, Varrassi G, Viswanath O, Urits I. Aranke M, et al. Anesth Pain Med. 2021 Feb 24;11(1):e112832. doi: 10.5812/aapm.112832. eCollection 2021 Feb. Anesth Pain Med. 2021. PMID: 34221949 Free PMC article. Review.
Cited by
- Deregulation of keratinocyte differentiation and activation: a hallmark of venous ulcers.
Stojadinovic O, Pastar I, Vukelic S, Mahoney MG, Brennan D, Krzyzanowska A, Golinko M, Brem H, Tomic-Canic M. Stojadinovic O, et al. J Cell Mol Med. 2008 Dec;12(6B):2675-90. doi: 10.1111/j.1582-4934.2008.00321.x. Epub 2008 Mar 28. J Cell Mol Med. 2008. PMID: 18373736 Free PMC article. - Incidence and cost burden of post-thrombotic syndrome.
Ashrani AA, Heit JA. Ashrani AA, et al. J Thromb Thrombolysis. 2009 Nov;28(4):465-76. doi: 10.1007/s11239-009-0309-3. Epub 2009 Feb 18. J Thromb Thrombolysis. 2009. PMID: 19224134 Free PMC article. Review. - Subfascial endoscopic perforator surgery (SEPS) for treating venous leg ulcers.
Lin ZC, Loveland PM, Johnston RV, Bruce M, Weller CD. Lin ZC, et al. Cochrane Database Syst Rev. 2019 Mar 3;3(3):CD012164. doi: 10.1002/14651858.CD012164.pub2. Cochrane Database Syst Rev. 2019. PMID: 30827037 Free PMC article. - Low-frequency (<100 kHz), low-intensity (<100 mW/cm(2)) ultrasound to treat venous ulcers: a human study and in vitro experiments.
Samuels JA, Weingarten MS, Margolis DJ, Zubkov L, Sunny Y, Bawiec CR, Conover D, Lewin PA. Samuels JA, et al. J Acoust Soc Am. 2013 Aug;134(2):1541-7. doi: 10.1121/1.4812875. J Acoust Soc Am. 2013. PMID: 23927194 Free PMC article. Clinical Trial. - Therapeutic ultrasound for venous leg ulcers.
Cullum N, Liu Z. Cullum N, et al. Cochrane Database Syst Rev. 2017 May 15;5(5):CD001180. doi: 10.1002/14651858.CD001180.pub4. Cochrane Database Syst Rev. 2017. PMID: 28504325 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources