Healing Australia’s chronic wound problem

New AMA modelling shows the crippling costs of wound care could be mitigated through targeted investment, saving the health system $203.4 million over the next four years. 

An AMA report, Solutions to the chronic wound problem in Australia, says chronic wound care is a poorly understood, under-funded public health issue affecting 450,000 Australians and cost $3 billion each year.

The report calls for Commonwealth support for GPs to provide high quality wound care for patients through a new national scheme to fund medical dressings for chronic wounds as well as extra Medicare funding to cover the unmet costs of providing care for patients suffering chronic wounds.

The modelling shows the burden chronic wounds place on an already stretched hospital system, accounting for close to 32,000 hospital admissions in 2019–20 costing $352 million and 249,346 patient days.

AMA Vice President Dr Danielle McMullen said the AMA’s analysis shows investing $23.4 million over four years to deliver best practice wound care for diabetic foot ulcers, arterial leg ulcers, and venous leg ulcers would save the health system $203.4 million.

“This is a no brainer for a government desperate to cut the deficit. I don’t know of many investments where for every $1.00 you spend, the return is $8.36, but this is the case with evidence-based wound care.”

Research shows additional Medicare funding for wound care would free up around 148,000 general practitioner consultations in the first year, and 162,000 consultations by the fourth year, making an enormous difference to patients.

“As GPs, we see some terrible consequences for patients if a wound isn’t managed properly, like amputations at the worst and nasty infections at least. They can take months or even years to heal and these are totally avoidable,” Dr McMullen said. 

“At the moment Medicare doesn’t cover the cost of the dressings needed to treat chronic wounds, so doctors are either bearing the costs themselves or are forced to pass on the cost to patients, and that’s not something we like doing.

“There is a lack of awareness about the significance of chronic wounds in Australia, which means vulnerable patients, mostly older Australians, Aboriginal and Torres Strait Islander peoples, or patients with other chronic conditions, often suffer in silence and fall through the cracks in our health system.

The report proposes a five-point solution:

• A Commonwealth-funded wound consumables scheme to subsidise the cost of dressings and other consumables provided in general practice for patients with chronic wounds.
• The implementation of a stepped model of care for the management of chronic wounds, with improved access to other healthcare professionals involved in wound care such as podiatrists and dieticians, to form GP-led healthcare teams.
• Three new Medicare items to facilitate the stepped model of care, including a Medicare item to allow trained practices nurses, Aboriginal and Torres Strait Islander Health Practitioners or Aboriginal Health Workers to provide short-term treatment.
• Implementation of a national education and training program on the prevention and management of chronic wounds, with access to the consumables scheme and extra Medicare support linked to completion of this education and training.
• Improved coordination of wound care initiatives in the sector under a national program to reduce duplication of effort.

AMA President Professor Steve Robson launched the report at a well-attended press conference at Parliament House on Monday. 

The story was covered in the NewsCorp papers along with Dr McMullen’s opinion piece.