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The burden of costs on health services from patients with venous leg ulcers in Singapore
Authors:Nuraini Nazeha  Jia Yi Lee  Seyed Ehsan Saffari  Lingyan Meng  Pei Ho  Yi Zhen Ng  Nicholas Graves
Affiliation:1. Health Services and Systems Research, Duke-NUS Medical School, Singapore;2. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;3. Wound Care Innovation for the Tropics Programme, Skin Research Institute of Singapore, A*STAR, Singapore
Abstract:Healthcare costs arising from venous leg ulcers (VLU) are expected to increase due to an aging population and increased prevalence of comorbidities. We aim to estimate the healthcare resources incurred by VLU patients, and to quantify the extent to which predictors explain variation in cost-related outcomes. Retrospective patient-level cohort data for VLU patients were analysed using generalised linear regression models. Data were extracted from a tertiary hospital registry in Singapore, between 2013 and 2017. The outcome variables were length of stay per admission; inpatient and outpatient bill per admission; whether a patient underwent a surgical treatment of the venous system; and, whether they visited the emergency department. Cost outcomes were reported in Singapore dollars (S$). A total of 162 VLU patients were included with a mean age of 67.5 (±14.4). For the inpatient setting the mean length of stay was 8.1 days and the mean inpatient bill was S$7886. For outpatients, the mean number of dressings was 29.4, and mean outpatient bill was S$6962. Heart disease patients incurred longer hospital stays and larger inpatient bills per admission and females had greater odds of undergoing a surgical procedure on the venous system. Certain VLU patient groups were found to be associated with larger cost outcomes.
Keywords:chronic leg ulcer  chronic wound  economic burden  venous leg ulcer
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