Prioritizing wound care to reduce hospitalizations and cut costs

By
Kristie Jones
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Wound care costs Ontario at least $1.5 billion annually in direct costs

Wounds Canada urges the Government of Ontario to prioritize wound care, ensuring that patient care is equitable, timely, non-fragmented and accessible across the province.

To improve patient care, reduce hospitalizations and lower spending on wounds, key actions must include:

  • Developing policies that prevent wounds such as pressure injuries (bed sores) and infected wounds in acute and home care settings
  • Increasing wound-related education for health-care providers, patients and families
  • Ensuring Ontario’s interprofessional teams include wound experts
  • Implementing wound care pathways from hospitals to home and community care with set measurables, monitoring and evaluation
  • Providing access to products and technology that are evidence-based and improve patient outcomes

Implementing these key actions would improve patient outcomes and reduce spending on wounds

  • On a daily basis, people are admitted to hospitals for infected wounds and are dying from pressure-related injuries (bed sores). Every four hours an amputation due to diabetic foot ulcers takes place, and new research shows this number is on the rise.
  • In Ontario evidence-based wound care is not integrated and equitably accessible to patients. For example, interprofessional teams often do not have access to basic wound care products such as advanced dressings. Health-care professionals do not have access to standard of care technology and practices that could detect and prevent pressure injuries from developing.
  • With investment in better wound prevention and management earlier on in the patient journey, the Government of Ontario could improve patient outcomes, reduce hospitalizations and readmissions, and quickly cut health-care costs related to wounds.
    • For example, adoption of best practices could reduce wound costs in home care by 40–50 per cent – approximately 50 per cent of home care visits involve wound care.

A person’s hospitalization and home care needs increase with complex or severe wounds.

  • A person with a diabetic foot ulcer that heals as expected spends an average of 5 days in the hospital, emergency rooms and clinics, whereas a diabetic foot ulcer that results in an amputation increases this time to an average of 70 days.
  • A surgical wound that becomes infected increases a person’s hospitalization by 11 days in Canada.
  • Despite the fact that at least 70 per cent of all pressure injuries are preventable, 25 per cent of people in any care setting in Ontario have a pressure injury on any given day. Pressure injuries can extend a hospital stay by 4 to 11 days.

Wound care has not been prioritized in Ontario or across Canada. We can do better.

  • The Government of Ontario has taken initial steps: draft wound care pathways are currently being developed, and funding for offloading devices has been provided to help prevent amputations due to diabetic foot ulcers. However, more must be done.
  • Wound care pathways, education and other supports are standard in many nations such as the United Kingdom, Spain, Netherlands and Sweden. Yet Canada has fallen far behind its peers by not keeping up with advances in standard of care technology and implementing best practices.
  • Ontario needs better wound care policies to support best practice and pathways to ensure appropriate outcomes, access to wound care experts and basic education for patients and health care professionals (from nurses and family physicians to surgeons and chiropodists) and access to evidence-based technology and products.