title: Comparison of health care costs and hospital readmission rates associated with negative pressure wound therapies.
abstract: OBJECTIVE
  A retrospective national claims database analysis evaluated total and wound-related costs (eg, hospital readmission rates) for patients with chronic wounds treated with negative pressure wound therapy (NPWT), comparing NPWT-V (V.A.C. Therapy, KCI, an Acelity company, San Antonio, TX) and NPWT-O (other non-KCI models of NPWT, the brands of which were not known to the researchers).
  
  
  METHODS
  Patients with ≥ 1 NPWT claim from January 2009-June 2012 in outpatient settings in the United States were included, if they had continuous medical and pharmacy benefits for 12 months before the initial index date of their NPWT claim and at least 3 months post index. Mean total health care costs were assessed at 3 months and 12 months; wound-related hospital readmission rates were assessed at 3 months and 6 months. Cost differences between cohorts were analyzed by t test and readmission rates were analyzed by chi-square test.
  
  
  RESULTS
  At 3 months, the cohort of NPWT-V patients was significantly younger (59.2 vs 63.6 years, P < 0.01). The same patients were followed at 3, 6, and 12 months, although some fell out as time progressed. At the 3-month assessment, mean comorbidity scores did not differ between the NPWT-V group and the NPWT-O groups (3.38 vs 3.66). Total costs were lower for NPWT-V vs NPWT-O at 3 months ($35,498 vs $39,722, respectively; P = 0.08) and 12 months ($80,768 vs $111,212; P = 0.03). Significantly lower inpatient (P = 0.01), emergency room (P < 0.01), and home (P = 0.05) costs, despite higher (P = 0.04) NPWT costs, accounted for lower 12-month NPWT-V total costs. Wound-related readmission rates were significantly lower for NPWT-V at 3 months (5% vs 8%; P ≤ 0.01) and 6 months (6% vs 11%; P ≤ 0.01). For all wound types, NPWT-O patients had a 17-fold higher rate of switching to alternate NPWT models compared with NPWT-V patients.
  
  
  CONCLUSIONS
  In this retrospective analysis, NPWT-V patients had lower total costs, lower wound-related costs, and lower hospital readmission rates than NPWT-O patients at all time points assessed.
authors.affiliation: KCI, an Acelity company, San Antonio, TX; email: amy.law@acelity.com.
authors.forename: Amy
authors.initials: A
authors.lastname: Law
authors.affiliation: Optum Life Sciences, Eden Prairie, MN.
authors.forename: Anissa
authors.initials: A
authors.lastname: Cyhaniuk
authors.affiliation: Optum Life Sciences, Eden Prairie, MN.
authors.forename: Blake
authors.initials: B
authors.lastname: Krebs
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics* / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000191:economics* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000191:economics / Q000628:therapy*