AHRA Evidence Shows How Australia Can Reduce $3.5b Wound Care Burden

An Australian Health Research Alliance (AHRA) research program has shown that many Australians are not receiving the best possible wound care because of poor adherence to evidence-based standards, inconsistent and disparate training, insufficient policy co-ordination and the lack of provision for the reimbursement of wound care costs.

AHRA’s National Wound Care Initiative has proposed a multi-pronged evidence-based approach to addressing the ongoing issue of wound care, which is costing Australia at least $3.5 billion dollars a year. Manager of Strategic Projects at Western Australian Health Translation Network (WAHTN) Jo Wilkie said the standard of care for wound care should be the same for everyone.
“This significant national initiative provides the evidence base and research rigour to ensure that every Australian with a wound will receive the same standard of care, regardless of who they are, where they are and who’s treating them,” she said.

“Equally importantly it delivers evidence to support a compelling reduction in Australia’s wound care burden. Our first world health system has an inherent obligation to achieve this. If we did the right things, the total social, health and economic cost of wound care to patients, government and the community would be significantly reduced. “We are proposing a treatment that is more community-based and which we believe will result in more effective treatment over a shorter period of time. This approach would lower the burden on the primary care system, but also lower the cost to the hospital system, because fewer people will go to hospital with advanced wound problems.”

Wound care is a serious public health issue, with approximately 450,000 Australians currently living with chronic wounds. That number is projected to increase significantly as the Australian population becomes older and anticipated increase in incidence of diabetes and other chronic health conditions. In 2018, AHRA was appointed by the Federal Government to bring Australia’s wound care sector together to develop an evidence base and information which could guide the government as to how to address the problem. In response, AHRA entered into a partnership with Wounds Australia, resulting in a unique collaboration between researchers, clinicians, consumers and the community.

In a significant advance, the AHRA Wound Care Initiative’s research determined for the first time the real, rather than modelled, costs of wound care. The study, led by Jo Wilkie (WAHTN) and Professor Keryln Carville (Silverchain), used data from more than 2,500 hospital and general practice patients, aged care residents, and community care clients in Western Australia and Queensland to determine the number and types of wounds and their treatment costs.

In determining the real costs of wound care, AHRA found that the cost of treating different wound types varies significantly. Nonetheless, the researchers looked at the 54 most common types of wounds and by adding up the costs of consumable therapeutic products and nursing time, calculated the average cost of treating each type of wound based on data collected by Silverchain over a 12-month period. Wound care is estimated to cost taxpayers at least $3.5 billion to treat each year, not including patients’ own costs and the costs to the economy due to lost productivity.

“Management of acute and chronic wounds presents a significant workload and fiscal burden for Australian hospitals, primary health care settings, residential aged care facilities and community health services,” Jo Wilkie said. “We believe that access to best practice wound prevention and management would be improved if services and practitioners were reimbursed the average costs of wound treatments, and if not covered by other funding arrangements, the average cost of direct labour for performing the treatment procedures.”

“This initiative provides the evidence base and research rigour to ensure that
every Australian with a wound will receive the same standard of care,
regardless of who they are.”

In addition to wound care costing, the Wound Care Initiative undertook 3 other projects to help improve wound care in Australia. In partnership with Wounds Australia and WAHTN, Adjunct Professor Emily Haesler (Curtin) and Professor Keryln Carville (Silverchain) led the review and update of the Standards to produce the 4th Edition of the Australian Standards for Wound Prevention and Management (2023) which provides a contemporary, evidence-based framework for best practice in wound prevention and management of people with, or at risk of, wounds. The new edition broke ground by including a new standard to cover digital platforms and technologies.

Health Translation Queensland (HTQ), Health Translation South Australia and Monash Partners also worked in partnership with Wounds Australia as part of the Initiative to produce 2 open-access online resources to fill significant gaps in wound-related education and research networks in Australia.
The Wounds Research Directory is a database of Australian wound researchers and their work, which aims to strengthen wound research networks and promote easier sharing of evidence from research.
The complementary Wounds Education and Training Directory is a comprehensive source of ongoing courses in wound care and related fields.

Together, the directories aim to improve information-sharing and collaboration between researchers, healthcare professionals and consumers, making it easier for healthcare professionals to source quality professional development. Crucially, they are freely available to all researchers, clinicians and consumers.
Wounds Australia CEO Helen Jentz described the directories as ‘a game-changer’. “These unique resources will help drive wound care knowledge and practice and provide information to improve the level of care received by Australians living with wounds,” Ms Jentz said.

HTQ Executive Director Professor John Prins said the directories were an excellent example of how collaborative partnerships could translate knowledge into practice. “These directories have effectively addressed key challenges and barriers facing wound care at systemic, policy and practice levels, thereby helping to reduce the wound care burden in Australia,” Professor Prins said.

Dr Kathleen Finlayson from Queensland University of Technology (QUT) and Professor Allison Cowin from the University of South Australia led work on the Wound Research Directory. “Despite extraordinary advances in Australian wound care research in recent years, there has been limited capacity to share – and therefore build on – these successes,” Dr Finlayson said. “The Wounds Research Directory gives our talented researchers an important way to connect, share their work and learn from each other.”

AHRA also undertook 3 targeted literature scoping reviews to determine the extent and nature of wound research in Australia within the global context, and a gap analysis of research needs and priorities which will inform a proposed 5-year program of wound research. Jo Wilkie said that while AHRA’s work to date has had an impact, much remains to be done to improve wound care in Australia through due consideration and implementation of the findings of this initiative. “There remains an urgent need for a national, holistic and integrated approach to wound care that is embedded at systemic, policy and practice level,” she said. “We must continue to strive for a wound care system that is a) based on agreed national standards, b) strengthened by training that’s aligned to the standards, c) informed by research evidence and d) enabled by a truly collaborative approach.”

AHRA Wound Care Initiative – AHRA Members and Project Partners:
Stream 1 – Actual Wound Care Cost:
Western Australian Health Translation Network
Health Translation Queensland

Stream 2 – Updating Wound Care Standards:
Western Australian Health Translation Network
Wounds Australia

Stream 3 – Wounds Education and Training Directory:
Health Translation Queensland
Monash Partners

Stream 4 – Wounds Research Directory:
Health Translation Queensland
Health Translation South Australia

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