初级保健中慢性伤口的经济负担：一项关于成本和患病率的真实世界数据分析。

The financial burden of chronic wounds in primary care: A real-world data analysis on cost and prevalence.

作者信息

Díaz-Herrera Miguel Ángel, González-Durán Mónica, Rodríguez-Martínez Francisco Javier, Tujillo-Flores Gema, Tuset-Mateu Nuria, Verdú-Soriano Jose, Gea-Caballero Vicente, Sanllorente-Melenchón Albert, Almeda-Ortega Jesús, Cunillera-Puértolas Oriol, Acedo-Anta Mateo, Martínez-Riera José Ramón

机构信息

Unit of Complex Wounds South Metropolitan Primary Care. Catalan Institute of Health. L'Hospitalet de Llobregat, Barcelona, Spain.

Research group on chronic and complex wounds in primary care (GReFeC), Foundation University Institute for Research in Primary Health Care Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.

出版信息

Int J Nurs Stud Adv. 2025 Feb 14;8:100313. doi: 10.1016/j.ijnsa.2025.100313. eCollection 2025 Jun.

DOI:10.1016/j.ijnsa.2025.100313

PMID:40535786

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12175658/

Abstract

BACKGROUND

Chronic wounds place a substantial clinical and economic burden on health systems and significantly reduce the quality of life of those affected. However, there are no large-scale economic evaluations to assess costs based on data in a real-world environment.

OBJECTIVE

We aimed to analyse the costs of managing patients with chronic wounds (pressure injuries, ulcers of venous aetiology, ulcers of arterial aetiology, diabetes-related foot ulcers, and lower-limb ulcers of other aetiologies) in primary care in the southern area of Barcelona, Spain, through a 3-year real-world data analysis.

METHODS

The direct costs associated with specific treatment materials and primary care consultations were analysed using the electronic clinical records and financial management data of 54 primary care centres managed by the Catalan Institute of Health, which served a population ranging from 890,152 in 2015 to 939,747 in 2017.

RESULTS

Between 2015 and 2017, total expenditure was estimated at € 34,991,854 (Euros) (USD 39,548,000 -United States Dollars-). The cost of the specific treatment materials was € 8,455,787 (USD 9,555,885), with an annual average of € 2,818,596 (USD 3,185,295) and an increase of 18.5 % over the period. The cost of the consultations for chronic wound management was € 26,536,067 (USD 29,988,409). The cumulative annual prevalence of chronic wounds per 10,000 inhabitants was 86.70‱ in 2015, 88.03‱ in 2016 and 88.7‱ in 2017. Pressure injuries accounted for 46.39 % to 42.86 % of all chronic wounds. The direct extrapolation of chronic wounds costs to the total population of Spain was € 1,763,037,849 (USD 1,993,409,074) (mean annual average € 587,679,283 -USD 664,136,358-) during the study period, with a prevalence of 388,777 and an estimated peak of 413,897 in 2017.

CONCLUSION

We found that chronic wounds have a significant economic impact and should be considered in the planning and management of healthcare resources to ensure adequate and sustainable primary care services.

TWEETABLE ABSTRACT

Chronic wounds represent a significant clinical and economic burden in medical devices and consultations, costing 34.99 million euros over three years. Effective planning is essential for the sustainability of primary care services.

摘要

背景

慢性伤口给卫生系统带来了巨大的临床和经济负担，并显著降低了患者的生活质量。然而，目前尚无基于真实世界环境中的数据进行大规模经济评估以评估成本。

目的

我们旨在通过为期3年的真实世界数据分析，分析西班牙巴塞罗那南部地区初级保健中慢性伤口（压力性损伤、静脉性溃疡、动脉性溃疡、糖尿病相关足部溃疡及其他病因的下肢溃疡）患者的管理成本。

方法

利用加泰罗尼亚卫生研究所管理的54个初级保健中心的电子临床记录和财务管理数据，分析与特定治疗材料及初级保健会诊相关的直接成本，这些中心服务的人口数量从2015年的890152人到2017年的939747人不等。

结果

2015年至2017年期间，总支出估计为34991854欧元（4035.6万美元）。特定治疗材料的成本为8455787欧元（955.59万美元），年均2818596欧元（318.53万美元），在此期间增长了18.5%。慢性伤口管理会诊成本为26536067欧元（2998.84万美元）。每10000名居民中慢性伤口的累积年患病率在2015年为86.70‰，2016年为88.03‰，2017年为88,7‰。压力性损伤占所有慢性伤口的46.39%至42.86%。在研究期间，将慢性伤口成本直接推算至西班牙总人口得出成本为1763037849欧元（1993409074美元）（年均587679283欧元 - 664136358美元），患病率为388777例，2017年估计峰值为413897例。