Current home care expenditures for persons with leg ulcers.

OBJECTIVE

The purpose of this study was to gain a better understanding of the home care expenditures incurred in providing care to the population with leg ulcers.

DESIGN

The study was designed as a descriptive survey and was conducted over a 4-week period during March 1999.

SETTING AND SUBJECTS: Persons in a large Ontario urban center with an ulcer below the knee, including the foot, who were receiving nursing services in the home, were eligible for inclusion in the study.

INSTRUMENTS: A leg assessment tool, a supply usage form, and a visiting nurses log (all developed by the researchers for the study) were used to collect data.

METHODS

Home care nurses visited all clients and completed an in-depth assessment of their social, medical, and leg ulcer history. Legs were inspected, an ankle brachial pressure index score was determined, and ulcers were examined and measured. For each nursing visit, supply usage, travel and treatment times, and mileage were tracked.

RESULTS

During the study period, 2270 visits were made (mean treatment time = 26 minutes, mean travel time = 17 minutes) costing $80.62 (Canadian dollars). Supply costs were $21.06. The regional annual home care expenditures were conservatively estimated to be $1.3 million.

CONCLUSION

Costs could potentially be reduced by cutting the 40% visit time attributed to travel, decreasing the visit frequency to clients with minimal drainage, and attention to "best practice."