The Health Economic Impact of Living Cell Tissue Products in the Treatment of Chronic Wounds: A Retrospective Analysis of Medicare Claims Data

Autor: Adrian Barbul, Helen Gelly, Arti Masturzo
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Databases
Factual
Population
Dermatology
Living cell
Medicare
Insurance Claim Review
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Internal medicine
Claims data
medicine
Retrospective analysis
cellular and/or tissue-based products
health economics
Humans
dermal skin substitute
education
Reimbursement
Original Investigation
Aged
Retrospective Studies
Aged
80 and over
Skin
Artificial
Advanced and Specialized Nursing
education.field_of_study
bilayer cellular construct
business.industry
030208 emergency & critical care medicine
Retrospective cohort study
Health Care Costs
Skin Transplantation
Middle Aged
cryopreserved human skin allograft
United States
Hospitalization
Clinical trial
skin substitutes
chronic wounds
Charlson comorbidity index
Chronic Disease
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Wounds and Injuries
Female
Emergency Service
Hospital
business
wound care
Zdroj: Advances in Skin & Wound Care
ISSN: 1538-8654
1527-7941
DOI: 10.1097/01.asw.0000581588.08281.c1
Popis: Supplemental digital content is available in the text.
OBJECTIVE To investigate differences in wound-related costs; product waste; lower-extremity amputations; and number of applications, hospitalizations, and emergency room visits among patients treated with three cellular and/or tissue-based products. METHODS This retrospective intent-to-treat matched-cohort study analyzed the full Medicare claims dataset from 2011 to 2014. Patients who received either a bilayer cellular construct (BLCC), dermal skin substitute (DSS), or cryopreserved human skin allograft (CHSA) were concurrently matched for Charlson Comorbidity Index, age, sex, and region, resulting in 14,546 study patients. Key variables were reported at 60, 90, and 180 days after the first product application. RESULTS There were no statistically significant differences in the distribution of Charlson Comorbidity Index, age, sex, and region among cohorts. Wound-related costs and product wastage were lower for CHSA patients relative to both BLCC and DSS patients at all time intervals (P < .05). Patients treated with CHSA received fewer product applications than DSS at 90 and 180 days (P < .05). Amputations were significantly higher among patients treated with DSS than either CHSA or BLCC (P < .0001). CONCLUSIONS The data demonstrate that wound-related costs, product waste, amputations, and frequency of applications are lower for CHSA than DSS. Wound-related costs and product waste are lower for CHSA compared with BLCC. Further claims analysis and prospective clinical trials could help develop appropriate quality measures and reimbursement models to ensure smarter spending for the growing population of patients with chronic wounds.
Databáze: OpenAIRE
Externí odkaz: