Wounds , especially chronic wounds like diabetic foot ulcers , bedsores , charcot foot , radiation induced ulcers , major burns impose a major economic burden on both patients and caregivers. A team approach to these problems lessens their complication rate , reduces problems and reduces the long term burned on patients and families.
If we remember that about 25 – 40% of diabetic patients suffer from diabetic foot ulcers during their lifetime and that many of these patients especially in India are in the productive phases of their life, the socio economic burden can be understood especially in terms of limb loss of the breadwinner of the family. A patient without a diabetic foot ulcer compared to a patient with one, has to spend less on medical care on a regular basis. Also as many patients in India come to a health care giver either when they develop an ulcer or when they have a limb threatening infection and are then diagnosed to be diabetic, the costs of treatment go up phenomenally compared to when they are diagnosed earlier and put into preventive footwear and diabetes related foot education is provided.
Apart from limb loss or loss of life of the breadwinner of the family leading to reduction in earning capacity of the family and pushing them further down the economic scale, the presence of even a non productive member with a diabetic foot ulcer or diabetic foot wound orbedsores, or a member who is bedridden, sharply pushes up the amounts spent on medical care for the family, apart from the fact that in some families it may be difficult to offer prolonged care to such patients simply because the costs of care are extremely high and especially in families which subsist on daily wages it may be just impossible to take such patients for medical care till it is too late.
The costs of care for wounds like diabetic foot ulcers and bedsores are likely to keep increasing as newer and newer therapies come up, the population ages and longevity increases, leading to a greater population with chronic problems , leading to pressure on available healthcare resources and also for insured patients, insurance companies are unlikely to reimburse the costs of all therapies used to treat chronic ulcerations, limb infections, gangrene etc. In such a scenario the case for a multidisciplinary team which focuses on prevention , early recognition and multi modality treatment, becomes stronger as it will have a short term as well as long term impact on reducing health care costs for the diabetic foot and other chronic wounds.