University of Twente Student Theses


Effect of transmural wound care treatments on the Wound Expertise Center of Medisch Spectrum Twente in terms of costs and wound healing

Bokhoven, D.M. (2020) Effect of transmural wound care treatments on the Wound Expertise Center of Medisch Spectrum Twente in terms of costs and wound healing.

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Abstract:Objective: Patients with peripheral arterial occlusive disease (PAOD) can develop complex wounds. Treatment is fragmented over several disciplines, leading to inefficient care. Specialized, multidisciplinary Wound Expertise Centers (WEC) are needed. WECs use integrated chain-based care for faster diagnosis and to deliver the best care at the best position, based on quality of care and costs. Since 2016, the WEC of Medisch Spectrum Twente has become functional. The question remains how effective this transmural person-oriented care is, looking at wound healing and costs. Methods: This was a retrospective observational study of PAOD-patients with complex wounds who received a conservative treatment plan at the WEC. Patients’ characteristics and wound data was collected from the health records. Incomplete data was inquired via a questionnaire. An indication was made of the transmural care disciplines. Prices accompanying the treatments were identified via literature orinvolved organizations. The total costs for treatment was analyzed per patient until wound healing. Results: 157 patients were included with a mean age of 76,6 years. 59,9% was male. 68,2% are (former) smokers. 38,9% had a diabetic ulcer. 59,9% was WIfI-classified with a very low risk of amputation, 62,4% with a very low risk of a revascularization procedure. 52 patients participated in the questionnaire with a mean age of 72,9 years. The mean healing time was 18,3 weeks. 71,2% received wound care via home care. The mean costs for all treatments was €7013,80. The highest costs were wound care via home care (mean €5279,89). Conclusion: With a conservative treatment plan most wounds healed within half a year with extramural treatments. The total treatment costs until wound healing was lower than the costs for wound healing without a WEC. Therefore, can be concluded that conservative home care treatments can be effective for the WEC to heal a wound faster and cheaper than without the WEC.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 83 economics
Programme:Health Sciences MSc (66851)
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