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Lifetime cost of chronic ulcers requiring hospitalization in Ontario, Canada: a population-based study


Objective — To determine the lifetime cost-of-illness of chronic ulcers from the perspective of the Ontario public healthcare payer.

Methods — We calculated healthcare costs for a cohort of individuals hospitalized for a diabetic foot ulcer, pressure ulcer or leg ulcer between 2005 and 2011 using Ontario administrative healthcare data. Lifetime costs for this cohort were estimated using phase-based costing methods. Net cost was determined by calculating the difference in lifetime costs between the chronic ulcer cohort and a matched non-chronic ulcer cohort. Matching was conducted using a combination of hard matching and propensity score methods. The chronic ulcer cohort represents all individuals residing in Ontario, Canada.

Results — A total of 7316 individuals with chronic ulcers were identified and matched with a non-chronic ulcer cohort (5583 diabetic foot ulcer, 1470 pressure ulcer, 262 leg ulcer). Lifetime net modeled cost of diabetic foot ulcer was $619,300 (95% CI $593,900–$642,800), for pressure ulcer $98,500 (95% CI $88,300–$109,100) and for leg ulcer $548,100 (95% CI $524,400–$569,500).

Conclusions — Chronic ulcers present a substantial economic burden to the healthcare system. Healthcare decision makers are encouraged to consider additional resources to preventative interventions for chronic ulcers to reduce downstream costs.



Chan CF, Cadarette SM, Wodchis WP, Mittmann N, Krahn MD. Wound Med. 2018; 20:21-34. Epub 2018 Jan 6.

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