"World Heath Care Congress Affordable Health Innovations Exhibit and Awards" 7th Annual World Health Care Congress 2010

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Chronic wounds mostly affect people over the age of 60. The incidence is 0.78% of the population and the prevalence ranges from 0.18 to 0.32%. As the population ages, the number of chronic wounds is expected to rise. The vast majority of chronic wounds can be classified into three categories: venous ulcers, diabetic, and pressure ulcers. Venous ulcers, which usually occur in the legs, account for about 70% to 90% of chronic wounds and mostly affect the elderly. Another major cause of chronic wounds, diabetes, is increasing in prevalence. Diabetics have a 15% higher risk for amputation than the general population due to chronic ulcers. Another leading type of chronic wounds is pressure ulcers, which usually occur in people with conditions such as paralysis that inhibit movement of body parts that are commonly subjected to pressure such as the heels, shoulder blades, and sacrum.12,13 The cost of chronic wound care is staggering. A study by the Agency for Healthcare Research and Quality (formerly Agency for Health Care Policy and Research) estimated that the national cost of pressure ulcer management exceeded $1.4 billion annually. The average cost to heal one leg ulcer is estimated at $1,951, whereas that for a diabetic foot ulcer is estimated at $29,373. With finite resources available a coordinated, efficient process for care across the continuum needs to be established. Considering the sites of service that typically provide chronic wound care it may occur in the acute care setting, the outpatient setting, the extended care setting, home health and/or the emergency department. In this model when a patient enters the system at any of these points, the patient will be assigned a care coordinator. The care coordinator will be the point of contact working with the health care team following evidenced-based pathways and communicate with the patient and the team as the patient moves through treatment. If the patient is transferred from one site in the continuum to another the care coordinator is still the point of contact for consistent and efficient care. After the patient is healed the care coordinator remains in contact for a period of time to guide prevent care and work to prevent recurrence. In addition a clinical pathway will be followed in the emergency department that assesses patients admitted with cellulitus who can be more cost-effectively treated and released to outpatient wound care or home health as opposed to a costly acute care admission.

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