Health Economics
Four-layer bandage systems (4LB) have been the traditional choice for the management of lower extremity edema. Though more expensive, a novel two-layer dual compression system bandage (2LB) has found favor due association with improved wound healing rates and patient compliance. The objective of this study was to estimate the time and labor costs of patients treated with a 4LB or 2LB system.
Methods:
All clinically indicated patients presenting at a single wound care center were included over the course of a single day. Patients were randomized to 4LB or 2LB system and a wound care technician applied the bandaged system. The total time of bandage application was calculated by an independent observer and divided by the total number of patients to determine the average. Labor costs were determined by multiplying the time by average labor and overhead costs.
Results:
A total of 40 patients were randomized to 4LB or 2LB over the course of one day and received a single leg wrap system. Over the course of the day, 46:00 minutes (2:18 minutes/limb) was spent applying the 4LB system versus 31:40 minutes (1:35 minutes/limb) applying the 2LB system. The 2LB system saved nearly 15 minutes over 20 patients. The labor and overhead costs associated with applying the 4LB and 2LB system was $19.93 and $13.72 for the day. The 2LB system was associated with a savings of $6.21 compared to patients receiving a 4LB system.
Discussion:
The 2LB system was associated with a substantial time reduction and cost savings in application. Over a 30-day period, 942 limbs are bandaged. If all were bandaged with a 2LB system, this would result in 11.25 hours in time savings and $292.54 in labor costs. When evaluating the use of a 2LB system labor costs should be included in the decision analysis. There is also the possibility of using that saved time more productively in the wound center in seeing more patients and a more in depth analysis of this health economic issue is in progress.
Trademarked Items: UrgoK2
References: 1. Ayman A. Grada, Tania J. Phillips, Lymphedema: Pathophysiology and clinical manifestations, Journal of the American Academy of Dermatology, Volume 77, Issue 6, 2017, Pages 1009-1020,
2. Benigni JP, Lazareth I, Parpex P, Gerard JL, Alves M, Vin F, Meaume S, Senet P, Allaert FA. Efficacy, safety and acceptability of a new two-layer bandage system for venous leg ulcers. J Wound Care. 2007 Oct;16(9):385-90. doi: 10.12968/jowc.2007.16.9.27866. https://pubmed.ncbi.nlm.nih.gov/17987751/
3. Hanna R, Bohbot S, Connolly N. A comparison of inferface pressures of three compression bandage systems. Br J Nurs. 2008 Nov 13-26;17(20):S16-24. doi: 10.12968/bjon.2008.17.Sup9.31661. https://pubmed.ncbi.nlm.nih.gov/19043323/
4. Jünger M, Ladwig A, Bohbot S, Haase H. Comparison of interface pressures of three compression bandaging systems used on healthy volunteers. J Wound Care. 2009 Nov;18(11):474, 476-80. doi: 10.12968/jowc.2009.18.11.45000. https://pubmed.ncbi.nlm.nih.gov/19901877/
5. Lantis JC 2nd, Barrett C, Couch KS, Ehmann S, Greenstein E, Ostler M, Tickner A. A dual compression system: preliminary clinical insights from the US. J Wound Care. 2020 Sep 1;29(Sup9):S29-S37. doi: 10.12968/jowc.2020.29.Sup9.S29. https://pubmed.ncbi.nlm.nih.gov/32924806/
6. Lazareth I, Moffatt C, Dissemond J, Lesne Padieu AS, Truchetet F, Beissert S, Wicks G, Tilbe H, Sauvadet A, Bohbot S, Meaume S. Efficacy of two compression systems in the management of VLUs: results of a European RCT. J Wound Care. 2012 Nov;21(11):553-4, 556, 558 passim. doi: 10.12968/jowc.2012.21.11.553. https://pubmed.ncbi.nlm.nih.gov/23413494/