Around half a million Australians suffer with a chronic wound. A chronic wound is one that is hard to heal. These include pressure injuries, venous leg ulcers and diabetes related foot ulcers. Some people have these wounds for weeks and months, or if untreated, they can suffer for years. Older people and those with chronic diseases such as diabetes and vascular disease are more likely to have a wound that is hard to heal.
Chronic wounds lead to physical and health complications, social and emotional issues and financial costs for sufferers and their families.
Physical and health complications. Sufferers are often in constant pain, have their mobility reduced and are predisposed to a number of potential complications. These may include wound infection, both at the site and throughout the whole body, which can result in cellulitis, constant pain, amputation or even death.
Social and emotional issues. People with a chronic wound are predisposed to mental health concerns such as depression and anxiety that has resulted from social isolation, changes to body image, and decreased quality of life.
Financial costs of chronic wounds. Chronic wounds cost Australia almost $3 billion a year in hospital and residential care alone. People with a chronic wound also face considerable out of pocket costs for treatment, wound dressing products and medications. For the individual, research has shown the cost of wound products to be between $86 and $340 per month, with some chronic wounds taking months to heal. Unfortunately these costs are often borne by people receiving the aged or disability pension, or those with a reduced income due to an inability to return to work.
The lack of community awareness around the risks of getting a wound and living with a wound are major barriers to prevention and management. Wounds are a hidden affliction: people who are at risk have little or no knowledge of what action to take when their wound doesn’t heal. Chronic wounds are a major health policy issue for politicians, governments, health policy makers, health care professionals and the general public. Yet the lack of awareness about wound issues among with these stakeholders is considerable.
With evidence based, best practice wound care, chronic wounds can be healed. Even difficult venous leg ulcers can be healed within 12 weeks. Research has demonstrated that best practice wound care saves the health system money. Wounds Australia commissioned economic analysis demonstrated potential savings in the order of $166 million p.a. to the Australian health care budget if all patients suffering from venous leg ulceration received appropriate compression therapy (based on 2012 data and costs). However reducing health care costs relies on access to treatment, use of appropriate dressings and compression bandages, and services provided by health care professionals with the skills and knowledge in wound care and prevention.
We can drive the change for best practice wound care for all Australians and reduce the suffering as a result of chronic wounds. To do this, Wounds Australia is calling for all political parties to support it’s Five Point Plan to reduce the burden of chronic wounds.
1. Medicare funding for treatment of chronic wounds in primary health care.
Currently wound care does not have a dedicated MBS item, despite being an integral part of care provided by doctors and nurses in general practice and community health settings. A dedicated MBS item for treatment of chronic wounds would enable GPs, nurses and allied health professionals to deliver the best practice multidisciplinary care to heal venous leg ulcers, diabetic foot ulcers and pressure injuries. Conservative estimates of potential savings to the health budget from reduced healing time and reduced hospitalisation for chronic wounds is $166 million annually for one type of chronic wound type alone (venous leg ulcers).
2. Subsidised wound products (dressings and related products) for people at risk of venous leg ulcers, diabetic foot ulcers and people aged 65+.
Subsidising wound products for these target populations will reduce the cost to the health system. Modern wound dressings, appropriately used, are extremely effective in the management of problems such as ulcers in elderly patients, enabling the patient to be treated in the community setting and stay out of hospital.
Wound dressings to treat chronic wounds can be expensive but they are a worthwhile investment. Research has shown that the use of less expensive dressings actually increases costs of treating a wound. This is because using the wrong dressing can mean it has to be changed more often, the wound takes longer to heal and the risk of complications increase. Funding access to the most appropriate dressings and products brings considerable savings to the overall health care system.
3. Raise awareness of chronic wounds through a public health campaign.
We need to raise community awareness and improve health literacy so that Australians understand the warning signs of chronic wounds and the availability of treatment for wounds that are not healing. It is important that the half a million people living with a chronic wound know that their wound can be healed. Our community should be aware of chronic wounds, who it as risk, how to prevent chronic wounds, warning signs and how to access help. Australian Government investment of $2 million over 4 years would enable a national roll out of a health awareness campaign that focusses on prevention and early access to treatment.
4. Wound Care training for primary health care and aged care workforces, particularly in rural and remote areas.
Access to training for those at the frontline of wound care treatment is needed. Evidence has shown that inconsistencies in wound management practice and outdated methods of practice contribute to high costs and poor patient outcomes. Continuing Professional Development for primary health care, aged care and rural and remote health care professionals will ensure best practice wound care is available to all Australians. Evidence based wound care training will deliver savings by keeping people out of hospital and reducing healing time. An investment of $0.75 million is needed to develop and rollout wound care training to primary health care, aged care and rural and remote workforces..
5. Map care pathways for chronic wound care.
Access to wound care is complex and confusing for patients and their families. This is particularly the case when a patient requires specialist treatment for complex wounds. Access to specialist wound clinics and specialist wound clinicians is patchy across Australia, particularly for people in rural and remote areas. Likewise the supply and availability of wound products is variable. Wounds Australia is proposing to conduct a national mapping exercise to identify pathways between primary health care and specialist services for chronic wound care. This would improve service planning, address access issues and reduce costly delays in referrals to specialist services. An estimated investment of $0.65m is required to undertake this project.