The study titled “Changes in Chronic Wounds and Medicare Costs” by our long-time friends Carter and coworkers, published in the Journal of Medical Economics, provides valuable insights into the cost of chronic wound care and the prevalence of chronic wounds among Medicare beneficiaries.
The objective of the study was to determine the cost of chronic wound care and the prevalence of chronic wounds across different wound types and healthcare settings from 2014 to 2019. The researchers conducted a retrospective analysis using Medicare claims data for beneficiaries with various types of chronic wounds.
The results of the study showed that over the 5-year period, the number of Medicare beneficiaries with chronic wounds increased from 8.2 million to 10.5 million. The prevalence of chronic wounds also increased by 13% from 14.5% to 16.4%. Notably, the largest increase in prevalence was observed among beneficiaries aged less than 65 years.
The study also examined healthcare expenditures associated with chronic wound care. Interestingly, despite the increase in prevalence, expenditures decreased over the study period. The researchers used three different methods to estimate expenditures: low, mid, and high. Regardless of the method used, there was a reduction in expenditures, with the most conservative method showing a decrease from $29.7 billion to $22.5 billion. However, the cost per wound decreased, with surgical wounds remaining the most expensive to treat.
Furthermore, the analysis revealed that there was a shift in chronic wound care expenditures from hospital-based outpatient departments to physician offices. Hospital outpatient fees saw the largest reduction, while home health agency expenditures also decreased. On the other hand, expenditures in physician offices and durable medical equipment increased.
In conclusion, the study suggests that chronic wound care expenditures have shifted to physician offices from hospital-based outpatient departments. With the increasing prevalence of chronic wounds, particularly among individuals under 65 years of age with disabilities, it is crucial to assess whether these shifts have positively or negatively impacted outcomes. The findings from this study shed light on the changing landscape of chronic wound care and its implications for Medicare costs.
Keywords: Medicare, chronic wounds, diabetes, cost of care
JEL codes: I18; I1; I; H51; H5; H
Running title: Changes in Chronic Wounds and Medicare Costs