Navigating the Current Wound Care Landscape Post-COVID-19 - Mr Tobe Madu

Navigating the Current Wound Care Landscape Post-COVID-19 Editorial Summary Encompassing a wound care database, the largest of its kind, this review culminates data from 439 facilities treating 3.6 million wounds and representing 12 million visits. The demand for advanced wound care has almost doubled in the space of a few years; the trends during and after the pandemic will be explored further in this article.

T

he COVID-19 pandemic turned the world upside down. What started as rumors of a potentially highly transmissible virus in China all but crippled the global economy. Borders were closed, the stock market plummeted, and the future could not have been more uncertain. The wound care industry was not left out of this carnage.

While the mainstream media focused on the effects of the virus on familiar activities like hotel stays and air travel, there was less emphasis on esoteric industries like wound care where data might not be readily available.

Despite the absence of wound care in regular conversation, chronic wounds occur in 1 out of every 100,000 U.S. citizens, and the number of people seeking help is poised to increase.

For those with wound issues, care is generally centered around closure or preventing serious complications to minimize hospitalization and surgery.

Mr Tobe Madu Data Scientist, Net Health Atlanta GA, United States

To better understand the impact of COVID-19 on the current wound care landscape, I analyzed a subset of the Net Health Wound Care database, one of the largest of its kind. The analysis included 439 facilities, which handled 3.6 million wounds representing 12 million visits dating back to 2012. In the next few paragraphs, I’ll share my observations and offer conjectures as to relevant causal or correlated factors.

Evidently, the demand for advanced wound care is growing as average wound care volume per facility at the beginning of the year has more than doubled when comparing 2022 to

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Wound Masterclass - Vol 1 - September 2022

the 2012 - 2019 period (Figure 1a). It is unclear how much of this growth may be due to a shift towards more higher volume facilities being represented in the database. Anecdotally, there are fewer new U.S. hospital-based wound centers opening, so the number of new patients is likely outpacing the current wound center infrastructure. If this observation holds true, it will be important to regularly examine the data and find patterns that can lead to a better understanding of where wound care is needed, and how resources could be efficiently deployed, so that those suffering can get the help they need.

With regards to the COVID-19 effect, we see that from January 2020 to April 2020, visit volume declined by a whopping 25%. This huge drop in visit volume in the first months of 2020 reflects the onset of pandemic awareness when there was a disruption of healthcare services due to lockdown mandates. In addition, many patients were taking a wait-and-see approach for fear of entering a healthcare facility and contracting the virus.

Looking at the trend, October historically is the highest volume month, with the month ranking in the top quartile for 7 of the last 10 years. This is likely because October is one of the longest months with 31 days, and with summer being over, people are probably home and close to their primary wound clinician. February, with 28 days and cooler winter weather, generally sees the least volume of the year.

As one can imagine, perverse weather conditions and other personal priorities affect patients’ ability to make appointments. This is

Navigating the Current Wound Care Landscape Post-COVID-19

“With an aging population and increasing prevalence of diabetes, the demand for wound care is growing and an acute awareness of operational metrics like visit volume will help facilities better navigate the changing landscape.”

supported by data, where for the 10-year period between 2012 to 2021, volumes in May, August and October tended to be higher than November, January and February, likely correlated to weather and holidays taking place during those months.

The COVID-19 pandemic created outliers to the historical data. However, once vaccinations became more widespread and people’s fears about seeing healthcare clinicians waned a bit, volume started inching towards preCOVID-19 levels. In December of 2021, visits peaked for the year, potentially due to pentup demand, vaccine availability and many COVID-19 restrictions being lifted. This was a clear deviation from the 2012 - 2019 trend where December, despite having 31 days, ranks relatively low among other months in terms of volume.

I also looked at the daily wound care visit volume per facility per month to account for working days, that is, excluding public holidays and weekends (Figure 1b). So far in 2022, wound care visits have shown signs of an uptick as fall approaches. Although the first few months of the year have been volatile, a peak between August and October followed by a relative decline in December could signal a return to trend. December declines will be in line with the thesis that patients skip on visits during holiday months. It could also be that they have exceeded their deductibles and health insurance allocations so wound care visits decrease.

Studies have suggested that the frequency with which patients visit wound care clinics influences the rate of chronic wound healing.

Understanding the dynamics around patient visits in a facility could help with decisions like the best time to start recruitment for clinical trials, or to schedule system upgrades for minimal disruption. With an aging population and increasing prevalence of diabetes, the

Figure 1a: Monthly wound care visit volume per facility shows signs of recovery in the first 6 months of 2022.

Figure 1b: Daily wound care visit volume per facility per month accounts for working days.

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1b

demand for wound care is growing and an acute awareness of operational metrics like visit volume will help facilities better navigate the changing landscape.

For those who haven’t been collecting data or utilizing it properly, now is the time to do so. It helps to know your numbers. By keeping track of fluctuations and investigating underlying causes, you can identify the strengths and weaknesses of your practice. As facilities better understand the numbers behind the operations, they can be better prepared to adopt data-based clinical practices.

Wound Masterclass - Vol 1 - September 2022

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