Cost analysis of one of the first outpatient wound clinics in the Netherlands.
OBJECTIVE
To perform, from an insurance perspective, a cost analysis of one of the outpatient community wound care clinics in the Netherlands, the Knowledge Centre in Wound Care (KCWC) at Venray.


METHODS
This study involved a cost analysis based on an observational cohort study with a one-year pre-admission and a one-year post-admission comparison of costs. Patients were included when they first consulted the outpatient wound care clinic. Participants were all insured by the same health insurance company, Coöperatie Volksgezondheidszorg (VGZ). A standard six-step procedure for performing cost studies was used to calculate the costs. Given the skewed cost data, non-parametric bootstrapping was used to test for statistical differences.


RESULTS
There were 172 patients included in this study. The difference in costs related to wound care between the year before and the year after initial admission to the wound clinic amounted to an average reduction of €2621 (£1873) per patient in the base case analysis. The categories 'general practitioner', 'hospital care', 'mental health care' and 'transport' scored lower, indicating lower costs, in the year after admission to the wound clinic.


CONCLUSIONS
In this study, only the reimbursement data of patients of one health insurance company, and specifically only those made under the 2006 Dutch Health Insurance Act, were available. Because of the observational design, definitive conclusions cannot be made regarding a demonstrated reduction of costs in the year post admission. Nevertheless, this study is a first attempt of a cost analysis of an equipped outpatient wound clinic as an innovative way of responding to the increasing number of chronic wounds in the Netherlands. The calculations show that savings in wound care are possible.


BACKGROUND
A possible conflict of interest should be mentioned. First author AALM Rondas, PhD student at Maastricht University, is working at the KCWC wound clinic at Venray in the Netherlands as a physician. However, the research data were provided externally by Coöperatie Volksgezondheidszorg (VGZ) and checked by the academic co-authors, none of whom have a conflict of interest. The authors have no financial or commercial interest to declare.
De Zorggroep, Knowledge Centre of Wound Care, Venlo, the Netherlands.|Maastricht University, Caphri-School of Public Health and Primary Care, Department of Family Medicine, Maastricht.
A A L M
AA
Rondas
Maastricht University, Caphri-School for Public Health and Primary Care,, the Netherlands.
J M G
JM
Schols
Maastricht University, Caphri-School for Public Health and Primary Care,, the Netherlands.
R J G
RJ
Halfens
Health insurance company, Coöperatie Volksgezondheidszorg (VGZ), the Netherlands.
H R
HR
Hull
Centre for Infectious Disease Research, Diagnostics and Screening (RIVM), the Netherlands.
E E
EE
Stobberingh
Maastricht University, Caphri-School for Public Health and Primary Care,, the Netherlands.
S M A A
SM
Evers
D000553:Ambulatory Care / Q000191:economics*; D002908:Chronic Disease; D003365:Costs and Cost Analysis; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D009426:Netherlands; D014947:Wounds and Injuries / Q000451:nursing*
Netherlands; chronic wounds; cost analysis; cost-effectiveness; leg ulcer; pressure ulcer