Managing health care often seems like a choice between saving money and providing top-level care. But what if it turned out that the two goals are really one and the same? In some crucial ways, saving money is one of the best paths to better care, at least in the area of wound treatment.
No, that is not to suggest that slashing budgets will cure pressure injuries or that spending less on a dressing or mattress is a secret formula for better results. In most cases, the opposite is true. Cutting spending without making significant changes in treatment is likely to hurt, not help, overall health.
But with an aging population and more wounds to treat every year, the need to do more with less money has revealed a fascinating truth - focusing on improving the quality of life for patients with a eye toward saving money can help medical professionals achieve both goals more effectively.
Costs and Savings in Wound Care
According to public health expert, Paulo Alves, Assistant Professor in the Health Sciences Institute – Porto, at the Catholic University of Portugal, costs of wound treatment can be divided into four areas:
1. Local treatment - applying therapeutic steps to the wound itself, from cleaning and disinfecting to covering and monitoring progress of wound healing. This requires staff time, which must be factored into the costs.
2. Treatment duration - calculating the amount of time a wound needs to heal. The longer a wound takes to heal, the more staff time and materials are needed to treat it.
3. Wound dressing - putting the dressing on the wound in order to maximize healing. There are over a thousand dressings on the market; making a smart choice in this area could impact spending in each of the other areas as well.
4. Treatment frequency - determining the risk factor for each patient with the intention of reducing the number and duration of pressing injuries.
All of these factors work together to produce the total cost of care for the patient. Reducing the cost in one of them - bringing down the average treatment duration, for example - could mean that a facility succeeds in reducing the intensity of the wounds. That would lower the costs of local treatment and wound dressing and possibly reduce the risk of wounds coming back as well.
More Products, More Opportunities
Dr. Alves explains that the effectiveness of a product is measured by the overall health gains - the results obtained in decreasing the total costs of treatment. In other words, if a product improves health at a lower cost, it is more effective than the product or method it is replacing.
Dr. Alves cites wound dressings as an example. There are already thousands of wound dressings on the market. Choosing the right one, however, requires a wider view than simply focusing on the price point. There are health risks - and therefore potential financial consequences - to choosing one dressing over another.
Extrinsic risks include:
- Continuous dressing change
- Aggressive cleansing
- Misuse of antibiotics
That means that the cheapest wound dressing could wind up costing a great deal more in staff time through more frequent changing, and could put the patient at risk via cleansings that might be harmful. Overuse of antibiotics could make it harder to treat infections in the future.
On the other hand, if the dressing is chosen with the intention of improving the quality of life for the patient, medical professionals would look for dressings that might cost more but are particularly effective in reducing the treatment during or improving the local treatment.
By focusing on specific health benefits in the areas that impact costs, health managers could improve health care and save money simultaneously. They would reduce the risk of infection, reduce pain, and reduce the frequency of dressing change.
Staying on the Right Track
One danger, Dr. Alves warns, is the possibility that products and treatments will be presented as quality improvements when in reality they are primarily implemented to save money. Transparency in intentions is key.
Keeping the focus on improving the quality of life for the patient will help direct decisions toward better outcomes. When those outcomes improve the overall delivery of health care in the four areas Dr. Alves describes, costs will often decrease as well.
Quality of life, however, will mean different things to different people. Constant input from the patient is the most important feedback when it comes to wound care.