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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Acta Vulnologica 2007 September;5(3):89-103
Clinical and Economic impact of a community outpatient Wound Care Centre
Longobardi P. 1, Piccinini E. 2, Poddie D. 3, Caruso B. 4, Laghi F. 5, Aimola A. 6, Zappi A. 7, Di Ruscio E. 8, Carradori T. 6
1 Centro Cura Ferite Difficili c/o Centro iperbarico, Ravenna
2 Unità di Chirurgia Vascolare P.O.S.M. delle Croci, Ravenna
3 Dipartimento Chirurgia, Ausl, Ravenna
4 Direzione Sanitaria P.O.S.M. delle Croci, Ausl, Ravenna
5 Direzione Distretto Ravenna, Ausl, Ravenna
6 Direzione Generale Ausl, Ravenna
7 Direzione Sanitaria, IRST Meldola (FC)
8 Regione Emilia Romagna Servizio di Assistenza Distrettuale Medicina Generale Pianificazione e Sviluppo dei Servizi Sanitari, Bologna
Aim. With this study we wanted to assess the clinic and economic impact on hospitalization of a community Outpatient Wound Care Centre.
Methods. We analyzed the activity of the Centre since November 2003, when it became fully operational, up to December 2006, comparing the final data with the initial feasibility plan which indicated also a potential demand evaluation of 1,577 patients with problem wounds in an area with a population of 369,427. Out of 195 patients treated in 2006, we assessed the complexity of the case mix at admission in consideration of wound type (20% of cancer, rheumatic, vasculitic wounds) and seriousness (41% of wounds within C2-B2 grades of Falanga classification system).
Results. At dismissal, 85% of patients was healed or had improved, only 3% had been hospitalised for amputation. The impact on hospital admission was assessed evaluating the trend of ten DRGs (Diagnosis Related Groups) connected with wound care, with an average weight of 2.11 DRGs points. In 2006 we reported a dramatic reduction in hospital admissions for four DRGs, compared to 2003 and, globally a decrease of 1829 days of hospitalisation with a reduced production per admission of 210.31 DRGs points equal to a saving of 232,975.79 euros.
Conclusion. Results proved that a Wound Care Centre can satisfy efficiently the population increased needs for chronic wound treatment. The centre had an impact in significantly cutting back the expenses of hospital admission for pathologies related to chronic wounds. Treatment efficacy was excellent despite wound seriousness at admission.