As wound care clinicians, we need to take into consideration many different factors in deciding on a treatment plan for our wound patients. Our patients should be evaluated on an individual basis. If we look at our patient’s socioeconomic status, we will find it varies from patient to patient. Socioeconomic status clearly affects morbidity and mortality rates related to wounds: wound management tends to be lower in quality and follow-up visits tend to be fewer in number when compared with patients with better economic status.¹

Socioeconomic Factors Affecting Wound Management

Socioeconomic factors can be big stressors for patients. Patients want their wounds to heal but feel helpless. We, as compassionate health care clinicians, feel the frustration for our patients. Patients miss follow-up appointments because they lack gas money, access to transportation, or caregiver support to assist with transportation. What can we do to help? There are some hospitals throughout the country that have free shuttle services to and from the wound center. This helps relieve the burden for the patient and provides more consistent wound management. Most recently, there are companies that are similar to Uber, but for health care needs. The following list provides examples of barriers to wound management:^1,2

1. Lack of transportation
2. Job loss
3. Insufficient monthly income
4. Lack of caregiver or attendant availability
5. Cost of sickness
6. Uninsured status
7. Inadequate insurance (out of pocket expenses, no reimbursement)

Strategies to Help Mitigate Socioeconomic Factors

A change is needed in providing education to our communities. Free education about chronic diseases and management can prevent an exacerbation of a condition. Preventive care goes a long way. In any health care setting, there are ways for us as health care clinicians to provide free resources to reduce extra costs. Chronic wound costs are a burden to our health care system. What can you do to help? Following are a few ideas we can share with our patients:

1. Free education
2. Free resources
3. Free diabetic, venous screening
4. Free wound care through clinical study trials (colleges of podiatry, wound care clinics, etc.)
5. Using social media to provide free preventive and treatment education

Selecting Cost-Effective Dressings

The wound care market contains over 6,000 wound care dressings. The reimbursement rates are driven by the Centers for Medicare & Medicaid Services (CMS) guidelines system. But what if our patient doesn’t have insurance? There is a wide selection of cost-effective dressing supplies that we can utilize to help lessen the strain on our patient’s wallet, such as gauze dressings, paper tapes and hydrogels. Another factor to consider is the expense of wound care. Choosing a dressing that may cost a bit more but that offers extended wear time may decrease dressing change frequency and the nursing time on the patient, improving the overall cost of care to treat the wound. Also take into consideration the payer source when making your dressing selections. There may also be copay assistance programs, or coupons available for certain topical agents, so assess your patient's unique situation and all the options therein.

Conclusions

Wound management can end up being a costly crisis for patients without adequate insurance or who have a lack of resources. Wound clinicians and providers can help contain the cost of care for their patients by tapping into other free resources and utilizing dressings that are most cost-effective. Knowing the socioeconomic status of your patient before planning and treating a wound can help in making the best treatment plan. Health care clinicians thinking outside the box will help those patients with specific economic needs.

Note: The information provided herein is for informational purposes. Always refer to manufacturer information for Indications, Warnings and Precautions for a specific product.

References

1. Paul-Satyaseela M, Hussain AC, Philip V. Socio-economic impact on wound management—a pilot study at a tertiary care Indian hospital. Wound Med. 2013;2–3:3–5. Available at: https://www.sciencedirect.com/science/article/pii/S2213909513000359. Accessed May 21, 2018.

2. Nametka MA, Amir L. Wound care during the economic downturn: how to stop the bleeding. Today’s Wound Clinic. 2009;3(4). Available at: http ://www.todayswoundclinic.com/articles/wound-care-during-economic-downturn-…. Accessed May 21, 2018.