{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:06:07Z","timestamp":1791443167905,"version":"4.3.3"},"reference-count":47,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T00:00:00Z","timestamp":1694908800000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Industry Alignment Fund-Pre-Positioning Programme","award":["H1901a00Y9\/ and H17\/01\/a0\/0CC9"],"award-info":[{"award-number":["H1901a00Y9\/ and H17\/01\/a0\/0CC9"]}]},{"DOI":"10.13039\/501100001348","name":"Agency for Science, Technology and Research","doi-asserted-by":"crossref","award":["H1901a00Y9\/ and H17\/01\/a0\/0CC9"],"award-info":[{"award-number":["H1901a00Y9\/ and H17\/01\/a0\/0CC9"]}],"id":[{"id":"10.13039\/501100001348","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,8,30]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the \u2018cost of illness\u2019 arising from chronic wounds in Singapore.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Incidence-based cost of illness study using evidence from a range of sources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Singapore health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We consider 3.49\u2009million Singapore citizens and permanent residents. There are 16\u2009752 new individuals with a chronic wound in 2017, with 598 venous ulcers, 2206 arterial insufficiency ulcers, 6680 diabetic ulcers and 7268 pressure injuries.<\/jats:p>\n                    <jats:p>Primary outcome measures expressed in monetary terms are the value of all hospital bed days lost for the population; monetary value of quality-adjusted life years (QALYs) lost in the population; costs of all outpatient visits; and costs of all poly clinic, use of Community Health Assist Scheme (CHAS) and emergency departments (EDs) visits. Intermediate outcomes that inform the primary outcomes are also estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total annual cost of illness was $350\u2009million (range $72\u2013$1779\u2009million). With 168\u2009503 acute bed days taken up annually (range 141\u2009966\u2013196\u2009032) that incurred costs of $139\u2009million (range 117\u2013161\u2009million). Total costs to health services were $184\u2009million (range $120\u2013$1179\u2009million). Total annual costs of lost health outcomes were 2077 QALYs (range \u22122657 to 29 029) valued at $166\u2009million (range \u2212212 to 2399\u2009million).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The costs of chronic wounds are large to Singapore. Costs can be reduced by making positive investments for comprehensive wound prevention and treatment programmes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-065692","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T22:57:12Z","timestamp":1695077832000},"page":"e065692","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Chronic wounds in a multiethnic Asian population: a cost of illness study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5559-3267","authenticated-orcid":false,"given":"Nicholas","family":"Graves","sequence":"first","affiliation":[{"name":"Health Services and Systems Research, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganga","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Health Services Research, Ministry of Health, 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Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5685-4329","authenticated-orcid":false,"given":"Priya","family":"Bishnoi","sequence":"additional","affiliation":[{"name":"A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Carmody","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang Shin","family":"Yuh","sequence":"additional","affiliation":[{"name":"Nursing Division, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi Zhen","family":"Ng","sequence":"additional","affiliation":[{"name":"A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwen","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vascular Surgery Woodlands Health, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Enming","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-5068","authenticated-orcid":false,"given":"Fazila","family":"Abu Bakar Aloweni","sequence":"additional","affiliation":[{"name":"Nursing Division, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Zifei","sequence":"additional","affiliation":[{"name":"Skin Research Institute of Singapore (SRIS), 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