{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:12:25Z","timestamp":1793751145662,"version":"4.6.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Chronic wounds pose considerable financial challenges for healthcare systems globally, with most cases requiring hospital care and extended lengths of stay, particularly due to delayed access to treatment. To address this, Sydney Local Health District (LHD) in Australia launched the Wound Care Command Centre\u2122 in 2023, utilising a digital application for timely access to wound care and to reduce the burden on hospitals. This study evaluates the cost consequences of this Centre by comparing healthcare service use under this new model of care compared to service use under standard clinical practice after one year of operation to determine savings to the health system.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Admitted patient, non-admitted and emergency department patient records relating to chronic wounds between 2018 and 2024 were analysed to determine service use costs, number of chronic wound admissions, length of stay, non-admitted services and emergency department presentations. Regression was used to control for patient mix, and records from a neighbouring LHD utilising the standard clinical care model was used as a control for this study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We estimated that with the Wound Care Command Centre\u2122, in 2023 there were up to 97 chronic wound admissions prevented, 943 hospital days averted due to earlier discharges, 308 more non-admitted service events and 208 more emergency department presentations in Sydney LHD, compared to expected levels under standard clinical practice models. This was consistent with reduced prevalence of complex cellulitis admissions in Sydney LHD and partial shifting of care from admitted to outpatient settings. Reduced hospital admissions and earlier discharges were estimated to total between $3.2\u00a0M to $4.8\u00a0M and costs of non-admitted and emergency department services were estimated to total $264k. After accounting for $1.3\u00a0M operational costs for the Command Centre over 2023, net savings were between $1.7\u00a0M to $3.3\u00a0M.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The Wound Care Command Centre\u2122 reduced hospital admissions by 97 individuals and shortened hospital length of stays by 1.1\u00a0day, resulting in savings up to $3.3\u00a0M for Sydney LHD. Additional benefits for patients included increased access to specialist advice through\u00a0the Wound Care Command Centre\u2122 and reduced face-to-face contact due to use of a digital platform minimising unnecessary hospital visits for patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12913-025-12969-2","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T10:58:55Z","timestamp":1751367535000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Digitising wound care: a cost-consequence analysis of the Wound Care Command Centre\u2122 in Australia"],"prefix":"10.1186","volume":"25","author":[{"given":"Michelle","family":"Barakat-Johnson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meg","family":"Newton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crispin","family":"Cayley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Dixie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Pelusi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"12969_CR1","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.jgar.2021.05.010","volume":"26","author":"M Falcone","year":"2021","unstructured":"Falcone M, De Angelis B, Pea F, Scalise A, Stefani S, Tasinato R, et al. Challenges in the management of chronic wound infections. J Glob Antimicrob Resist. 2021;26:140\u20137.","journal-title":"J Glob Antimicrob Resist"},{"key":"12969_CR2","unstructured":"Aged Care Quality and Safety Commission. Avoiding common wound management mistakes. Australian Government; 2024. Available from: https:\/\/www.agedcarequality.gov.au\/news-publications\/latest-news\/avoiding-common-wound-management-mistakes."},{"key":"12969_CR3","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.annepidem.2018.10.005","volume":"29","author":"L Martinengo","year":"2019","unstructured":"Martinengo L, Olsson M, Bajpai R, Soljak M, Upton Z, Schmidtchen A, et al. Prevalence of chronic wounds in the general population: systematic review and meta-analysis of observational studies. Ann Epidemiol. 2019;29:8\u201315.","journal-title":"Ann Epidemiol"},{"issue":"3","key":"12969_CR4","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/iwj.12538","volume":"13","author":"RE Norman","year":"2016","unstructured":"Norman RE, Gibb M, Dyer A, Prentice J, Yelland S, Cheng Q, et al. Improved wound management at lower cost: a sensible goal for Australia. Int Wound J. 2016;13(3):303\u201316.","journal-title":"Int Wound J"},{"issue":"2","key":"12969_CR5","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1111\/wrr.12994","volume":"30","author":"E Eriksson","year":"2022","unstructured":"Eriksson E, Liu PY, Schultz GS, Martins-Green MM, Tanaka R, Weir D, et al. Chronic wounds: treatment consensus. Wound Repair Regeneration. 2022;30(2):156\u201371.","journal-title":"Wound Repair Regeneration"},{"key":"12969_CR6","unstructured":"Pacella R, et al. Solutions to the chronic wounds problem in Australia: a call to action. Wound Pract Res. 2018;26(2):84\u201398."},{"issue":"1","key":"12969_CR7","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1186\/s12913-022-07829-2","volume":"22","author":"NC Coombs","year":"2022","unstructured":"Coombs NC, Campbell DG, Caringi J. A qualitative study of rural healthcare providers\u2019 views of social, cultural, and programmatic barriers to healthcare access. BMC Health Serv Res. 2022;22(1):438.","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"12969_CR8","first-page":"7769","volume":"23","author":"A Maganty","year":"2023","unstructured":"Maganty A, Byrnes ME, Hamm M, Wasilko R, Sabik LM, Davies BJ, et al. Barriers to rural health care from the provider perspective. Rural Remote Health. 2023;23(2):7769.","journal-title":"Rural Remote Health"},{"issue":"1","key":"12969_CR9","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1080\/13696998.2023.2232256","volume":"26","author":"MJ Carter","year":"2023","unstructured":"Carter MJ, DaVanzo J, Haught R, Nusgart M, Cartwright D, Fife CE. Chronic wound prevalence and the associated cost of treatment in medicare beneficiaries: changes between 2014 and 2019. J Med Econ. 2023;26(1):894\u2013901.","journal-title":"J Med Econ"},{"issue":"1","key":"12969_CR10","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1111\/iwj.12996","volume":"16","author":"L McCosker","year":"2019","unstructured":"McCosker L, Tulleners R, Cheng Q, Rohmer S, Pacella T, Graves N, et al. Chronic wounds in Australia: A systematic review of key epidemiological and clinical parameters. Int Wound J. 2019;16(1):84\u201395.","journal-title":"Int Wound J"},{"key":"12969_CR11","unstructured":"Wounds Australia. Pre-Budget Submission to fight Australia\u2019s chronic wound epidemic. 2022."},{"issue":"5","key":"12969_CR12","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1111\/iwj.13708","volume":"19","author":"X Zhu","year":"2022","unstructured":"Zhu X, Olsson MM, Bajpai R, J\u00e4rbrink K, Tang WE, Car J. Health-related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross-sectional study in Singapore. Int Wound J. 2022;19(5):1121\u201332.","journal-title":"Int Wound J"},{"key":"12969_CR13","unstructured":"Graves N, Zheng H. Modelling the direct health care costs of chronic wounds in Australia. Wound Pract Res. 2014;22(1):20\u201333."},{"issue":"6","key":"12969_CR14","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1111\/iwj.12796","volume":"14","author":"S Kapp","year":"2017","unstructured":"Kapp S, Santamaria N. How and why patients self-treat chronic wounds. 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What\u2019s the true costs of wounds faced by different healthcare systems around the world? Int Wound J. 2023;20(10):3935\u20138.","journal-title":"Int Wound J"},{"key":"12969_CR18","first-page":"379","volume":"310","author":"M Barakat-Johnson","year":"2024","unstructured":"Barakat-Johnson M, Kita B, Jones A, Burger M, Airey D, Stephenson J, et al. The viability and acceptability of a virtual wound care command centre in Australia. Stud Health Technol Inf. 2024;310:379\u201383.","journal-title":"Stud Health Technol Inf"},{"key":"12969_CR19","unstructured":"Sydney Local Health District. Health Matters: Issue 111, September 2023. 2023."},{"issue":"1","key":"12969_CR20","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1038\/s41746-023-00824-9","volume":"6","author":"KA McLean","year":"2023","unstructured":"McLean KA, Sgr\u00f2 A, Brown LR, Buijs LF, Daines L, Potter MA, et al. Evaluation of remote digital postoperative wound monitoring in routine surgical practice. 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Available from: https:\/\/www.ihacpa.gov.au\/sites\/default\/files\/2023-03\/tier_2_non-admitted_services_definition_manual_2023-24_0.pdf."},{"key":"12969_CR26","unstructured":"National Health and Medical Research Council, Australian Research Council and Universities Australia. National Statement on Ethical Conduct in Human Research. Canberra: National Health and Medical Research Council; 2023."},{"key":"12969_CR27","unstructured":"Australian Medical Association. Solutions to the chronic wound problem in Australia. 2022. Available from: https:\/\/www.ama.com.au\/sites\/default\/files\/2022-08\/research-report-solutions-to-the-chronic-wound-problem-in-australia.pdf."},{"key":"12969_CR28","doi-asserted-by":"crossref","unstructured":"D\u00edaz-Herrera M, Mart\u00ednez-Riera JR, Verd\u00fa-Soriano J, Capillas-P\u00e9rez RM, Pont-Garc\u00eda C, Tenllado-P\u00e9rez S, et al. Multicentre study of chronic wounds point prevalence in primary health care in the Southern metropolitan area of Barcelona. J Clin Med. 2021;10(4):797.","DOI":"10.3390\/jcm10040797"},{"issue":"3","key":"12969_CR29","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1111\/iwj.13325","volume":"17","author":"CN Parker","year":"2020","unstructured":"Parker CN, Finlayson KJ, Edwards HE, MacAndrew M. Exploring the prevalence and management of wounds for people with dementia in long-term care. Int Wound J. 2020;17(3):650\u20139.","journal-title":"Int Wound J"}],"updated-by":[{"DOI":"10.1186\/s12913-025-13510-1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000}}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-025-12969-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-025-12969-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-025-12969-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T21:02:59Z","timestamp":1758574979000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-025-12969-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["12969"],"URL":"https:\/\/doi.org\/10.1186\/s12913-025-12969-2","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]},"assertion":[{"value":"9 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 September 2025","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s12913-025-13510-1","URL":"https:\/\/doi.org\/10.1186\/s12913-025-13510-1","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study adhered to the ethical principles outlined in the Declaration of Helsinki.The study was part of a larger research initiative consisting of three stages. This cost study represents the third stage. Data from patients in stages 1 and 2 were utilised, as participants had already provided informed consent for their medical records to be accessed and their information to be used for research purposes.Additional aggregated data were collected from the Performance Unit at a health system level, ensuring that patients were unidentifiable. A waiver of consent was approved by Sydney Local Health District Ethics Review Committee (RPAH Zone) HREC\/2019\/ETH12459\/General Amendment with form ID 120632 protocol number X19-0307) the data, as the Ethics Committee deemed this component to pose no more than low risk, as it involved a retrospective audit of medical records and healthcare utilisation data at the health system level.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"873"}}