Why insurers should reimburse for compression stockings in patients with chronic venous stasis

Peter Korn, Sheela T. Patel, Jennifer A. Heller, Jonathan S. Deitch, K. V. Krishnasastry, Harry L. Bush, K. Craig Kent

Research output: Contribution to journalArticle

Abstract

Background: Chronic venous stasis ulcers produce substantial morbidity rates and result in a significant expense to society. Fortunately, compression stockings (CS) have been found to reduce the rate of recurrence in patients with previous ulceration. Surprisingly, Medicare and other insurers do not reimburse the expense associated with CS or with patient education (Ed), which is essential to ensure compliance. Methods: A Markov decision analysis model was used for analysis of the cost-effectiveness of a strategy of reimbursement for CS and Ed (prophylaxis) versus one that does not supply these resources in a 55-year-old patient with prior venous stasis ulceration. The mean time to ulcer recurrence (53 months with CS+Ed; 18.7 months without prophylaxis), the mean time for ulcer healing (4.6 months), the probabilities of hospitalization (12%) and amputation (0.4%) after the development of an ulcer, and quality-adjustment factors (0.80 during ulcer treatment) were derived from the literature. The cost of CS ($300/year) and Ed ($93 for initial evaluation; $58/year; $40/recurrence) and the medical cost of ulcer treatment (average cost, $1621/recurrence) were calculated from our hospital cost accounting system. Results: A strategy of CS and Ed was cost saving, with 0.37 quality-adjusted life years and $5904 saved, compared with a strategy that does not provide these resources. The inclusion of loss of revenue related to absence from work in the analysis increased cost savings to $17,080 during the patient's lifetime. With sensitivity analysis, CS and Ed remained cost-effective (lifetime cost per quality-adjusted life year saved,

Original languageEnglish (US)
Pages (from-to)950-957
Number of pages8
JournalJournal of Vascular Surgery
Volume35
Issue number5
DOIs
StatePublished - May 2002
Externally publishedYes

Fingerprint

Compression Stockings
Insurance Carriers
Ulcer
Education
Costs and Cost Analysis
Recurrence
Quality-Adjusted Life Years
Varicose Ulcer
Decision Support Techniques
Cost Savings
Hospital Costs
Patient Education
Medicare
Amputation
Health Care Costs
Compliance
Cost-Benefit Analysis
Hospitalization
Morbidity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Korn, P., Patel, S. T., Heller, J. A., Deitch, J. S., Krishnasastry, K. V., Bush, H. L., & Kent, K. C. (2002). Why insurers should reimburse for compression stockings in patients with chronic venous stasis. Journal of Vascular Surgery, 35(5), 950-957. https://doi.org/10.1067/mva.2002.121984

Why insurers should reimburse for compression stockings in patients with chronic venous stasis. / Korn, Peter; Patel, Sheela T.; Heller, Jennifer A.; Deitch, Jonathan S.; Krishnasastry, K. V.; Bush, Harry L.; Kent, K. Craig.

In: Journal of Vascular Surgery, Vol. 35, No. 5, 05.2002, p. 950-957.

Research output: Contribution to journalArticle

Korn, P, Patel, ST, Heller, JA, Deitch, JS, Krishnasastry, KV, Bush, HL & Kent, KC 2002, 'Why insurers should reimburse for compression stockings in patients with chronic venous stasis', Journal of Vascular Surgery, vol. 35, no. 5, pp. 950-957. https://doi.org/10.1067/mva.2002.121984
Korn, Peter ; Patel, Sheela T. ; Heller, Jennifer A. ; Deitch, Jonathan S. ; Krishnasastry, K. V. ; Bush, Harry L. ; Kent, K. Craig. / Why insurers should reimburse for compression stockings in patients with chronic venous stasis. In: Journal of Vascular Surgery. 2002 ; Vol. 35, No. 5. pp. 950-957.
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