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Development of a model to predict closure of chronic wounds in Germany: Claims data analysis
Patients with chronic leg ulcer, pressure ulcer, or diabetic foot ulcer suffer from significant disease burden. With a view to improving healthcare provision sustainably, a predictive model of time to closure (time‐to‐event analysis) based on claims data was developed. To identify potential predicto...
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Published in: | International wound journal 2022-01, Vol.19 (1), p.76-85 |
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description | Patients with chronic leg ulcer, pressure ulcer, or diabetic foot ulcer suffer from significant disease burden. With a view to improving healthcare provision sustainably, a predictive model of time to closure (time‐to‐event analysis) based on claims data was developed. To identify potential predictors of wound closure, clinical information absent from statutory health insurance (SHI) data was modelled. In patients with leg ulcers, age of the patient (hazard ratios [HR] 0.99), increasing number of comorbidities (HR 0.94), inpatient stays (HR 0.74), and treatment by a specialised wound care professional (HR 1.18) were significant predictors of time to closure (adjusted model). In almost all models, the number of inpatient stays and of comorbidities predicted a lower probability of healing. In addition, the age and the sex of the patient were found to be significant predictors in some models (leg ulcer: HR 0.99; pressure ulcer: HR 0.99). Increasing number of comorbidities and inpatient stays were predictors for closure time in all models. Since these predictors may give an indication of wound severity, further clinical information should be considered in future models, as also indicated by the moderate values of the c‐statistics. This requires future data linkage between SHI and primary studies (eg, registers). |
doi_str_mv | 10.1111/iwj.13599 |
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With a view to improving healthcare provision sustainably, a predictive model of time to closure (time‐to‐event analysis) based on claims data was developed. To identify potential predictors of wound closure, clinical information absent from statutory health insurance (SHI) data was modelled. In patients with leg ulcers, age of the patient (hazard ratios [HR] 0.99), increasing number of comorbidities (HR 0.94), inpatient stays (HR 0.74), and treatment by a specialised wound care professional (HR 1.18) were significant predictors of time to closure (adjusted model). In almost all models, the number of inpatient stays and of comorbidities predicted a lower probability of healing. In addition, the age and the sex of the patient were found to be significant predictors in some models (leg ulcer: HR 0.99; pressure ulcer: HR 0.99). Increasing number of comorbidities and inpatient stays were predictors for closure time in all models. Since these predictors may give an indication of wound severity, further clinical information should be considered in future models, as also indicated by the moderate values of the c‐statistics. 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International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4439-5fa1cb53851bc07830cb3532592307f2fdc45c613cc1d3488c97fc5007fb32c23</citedby><cites>FETCH-LOGICAL-c4439-5fa1cb53851bc07830cb3532592307f2fdc45c613cc1d3488c97fc5007fb32c23</cites><orcidid>0000-0002-4026-8728 ; 0000-0002-2676-1479 ; 0000-0003-1325-2883</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fiwj.13599$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fiwj.13599$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,50923,51032,53827,53829</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33949101$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hagenström, Kristina</creatorcontrib><creatorcontrib>Protz, Kerstin</creatorcontrib><creatorcontrib>Petersen, Jana</creatorcontrib><creatorcontrib>Augustin, Matthias</creatorcontrib><title>Development of a model to predict closure of chronic wounds in Germany: Claims data analysis</title><title>International wound journal</title><addtitle>Int Wound J</addtitle><description>Patients with chronic leg ulcer, pressure ulcer, or diabetic foot ulcer suffer from significant disease burden. With a view to improving healthcare provision sustainably, a predictive model of time to closure (time‐to‐event analysis) based on claims data was developed. To identify potential predictors of wound closure, clinical information absent from statutory health insurance (SHI) data was modelled. In patients with leg ulcers, age of the patient (hazard ratios [HR] 0.99), increasing number of comorbidities (HR 0.94), inpatient stays (HR 0.74), and treatment by a specialised wound care professional (HR 1.18) were significant predictors of time to closure (adjusted model). In almost all models, the number of inpatient stays and of comorbidities predicted a lower probability of healing. In addition, the age and the sex of the patient were found to be significant predictors in some models (leg ulcer: HR 0.99; pressure ulcer: HR 0.99). Increasing number of comorbidities and inpatient stays were predictors for closure time in all models. Since these predictors may give an indication of wound severity, further clinical information should be considered in future models, as also indicated by the moderate values of the c‐statistics. This requires future data linkage between SHI and primary studies (eg, registers).</description><subject>Age</subject><subject>chronic wounds</subject><subject>Data Analysis</subject><subject>Diabetes</subject><subject>Diabetic Foot - epidemiology</subject><subject>Diabetic Foot - therapy</subject><subject>Foot diseases</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Hydrogels</subject><subject>Infections</subject><subject>Leg Ulcer - epidemiology</subject><subject>Leg Ulcer - therapy</subject><subject>Leg ulcers</subject><subject>Older people</subject><subject>Original</subject><subject>Population</subject><subject>predictors</subject><subject>Prescriptions</subject><subject>Pressure distribution</subject><subject>Pressure ulcers</subject><subject>Primary care</subject><subject>Sociodemographics</subject><subject>Statistical analysis</subject><subject>statutory health insurance</subject><subject>wound closure</subject><subject>Wound Healing</subject><issn>1742-4801</issn><issn>1742-481X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kc1qGzEURkVISZw0i7xAEGTTLGzrZ-QZZVEobuskGLppaRYBobmjSWQ0I0eaifHbV64d0wSqzRV8h8O9fAidUzKi6Y3tajGiXEh5gAY0z9gwK-j94f5P6DE6iXFBCJNC5EfomHOZSUroAD18NS_G-WVj2g77Gmvc-Mo43Hm8DKay0GFwPvbBbFJ4Cr61gFe-b6uIbYtnJjS6XV_jqdO2ibjSnca61W4dbfyIPtTaRXO2m6fo1_dvP6c3w_mP2e30y3wIWcblUNSaQil4IWgJJC84gZILzoRknOQ1qyvIBEwoB6AVz4oCZF6DICkrOQPGT9HnrXfZl42pIN0StFPLYBsd1sprq94mrX1Sj_5FFZMi6TaCTztB8M-9iZ1qbATjnG6N76NigjEuJwUVCb18hy58H9LBUXEiyYRImW2EV1sKgo8xmHq_DCVq05lKnam_nSX24t_t9-RrSQkYb4GVdWb9f5O6_X23Vf4BDmSg5w</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Hagenström, Kristina</creator><creator>Protz, Kerstin</creator><creator>Petersen, Jana</creator><creator>Augustin, Matthias</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4026-8728</orcidid><orcidid>https://orcid.org/0000-0002-2676-1479</orcidid><orcidid>https://orcid.org/0000-0003-1325-2883</orcidid></search><sort><creationdate>202201</creationdate><title>Development of a model to predict closure of chronic wounds in Germany: Claims data analysis</title><author>Hagenström, Kristina ; Protz, Kerstin ; Petersen, Jana ; Augustin, Matthias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4439-5fa1cb53851bc07830cb3532592307f2fdc45c613cc1d3488c97fc5007fb32c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>chronic wounds</topic><topic>Data Analysis</topic><topic>Diabetes</topic><topic>Diabetic Foot - epidemiology</topic><topic>Diabetic Foot - therapy</topic><topic>Foot diseases</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Hydrogels</topic><topic>Infections</topic><topic>Leg Ulcer - epidemiology</topic><topic>Leg Ulcer - therapy</topic><topic>Leg ulcers</topic><topic>Older people</topic><topic>Original</topic><topic>Population</topic><topic>predictors</topic><topic>Prescriptions</topic><topic>Pressure distribution</topic><topic>Pressure ulcers</topic><topic>Primary care</topic><topic>Sociodemographics</topic><topic>Statistical analysis</topic><topic>statutory health insurance</topic><topic>wound closure</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hagenström, Kristina</creatorcontrib><creatorcontrib>Protz, Kerstin</creatorcontrib><creatorcontrib>Petersen, Jana</creatorcontrib><creatorcontrib>Augustin, Matthias</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>Wiley Online Library</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Complete (ProQuest Database)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International wound journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hagenström, Kristina</au><au>Protz, Kerstin</au><au>Petersen, Jana</au><au>Augustin, Matthias</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a model to predict closure of chronic wounds in Germany: Claims data analysis</atitle><jtitle>International wound journal</jtitle><addtitle>Int Wound J</addtitle><date>2022-01</date><risdate>2022</risdate><volume>19</volume><issue>1</issue><spage>76</spage><epage>85</epage><pages>76-85</pages><issn>1742-4801</issn><eissn>1742-481X</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Patients with chronic leg ulcer, pressure ulcer, or diabetic foot ulcer suffer from significant disease burden. With a view to improving healthcare provision sustainably, a predictive model of time to closure (time‐to‐event analysis) based on claims data was developed. To identify potential predictors of wound closure, clinical information absent from statutory health insurance (SHI) data was modelled. In patients with leg ulcers, age of the patient (hazard ratios [HR] 0.99), increasing number of comorbidities (HR 0.94), inpatient stays (HR 0.74), and treatment by a specialised wound care professional (HR 1.18) were significant predictors of time to closure (adjusted model). In almost all models, the number of inpatient stays and of comorbidities predicted a lower probability of healing. In addition, the age and the sex of the patient were found to be significant predictors in some models (leg ulcer: HR 0.99; pressure ulcer: HR 0.99). Increasing number of comorbidities and inpatient stays were predictors for closure time in all models. Since these predictors may give an indication of wound severity, further clinical information should be considered in future models, as also indicated by the moderate values of the c‐statistics. This requires future data linkage between SHI and primary studies (eg, registers).</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>33949101</pmid><doi>10.1111/iwj.13599</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-4026-8728</orcidid><orcidid>https://orcid.org/0000-0002-2676-1479</orcidid><orcidid>https://orcid.org/0000-0003-1325-2883</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Age chronic wounds Data Analysis Diabetes Diabetic Foot - epidemiology Diabetic Foot - therapy Foot diseases Germany - epidemiology Humans Hydrogels Infections Leg Ulcer - epidemiology Leg Ulcer - therapy Leg ulcers Older people Original Population predictors Prescriptions Pressure distribution Pressure ulcers Primary care Sociodemographics Statistical analysis statutory health insurance wound closure Wound Healing |
title | Development of a model to predict closure of chronic wounds in Germany: Claims data analysis |
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