Pedro Gaspar 1 Josep Monguet 2 Jordi Ojeda 2 João Costa 1 Rogério Costa 1

1. eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation Pedro Gaspar1 Josep Monguet2 Jordi Ojeda2 João Costa1 Rogério Costa1 1Polytechnic Institute of Leiria (IPL) - Portugal 2Polytechnic University of Catalonia (UPC) - Spain

2. Introduction eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey … 2.3 and 3.1 billion pounds (2005-2006 prices) per year in the UK (Posnett & Franks, 2008) … 7 billion dollars in the USA, in 2007 (in dressing materials alone) … … 20 billion if other costs (salaries, hospitalization, infection control…) are taken into consideration (Zaleski, 2008) economic burden prevalence & incidence Chronic Wounds THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

3. Introduction eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey technological advances … new equipment new materials evidence based practice diagnosis and treatment training THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

4. Introduction eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey In a context of fast-moving scientific and technological advances, knowledge acquired at school soon becomes outdated (Kokol, 2006). INFORMATION and COMMUNICATION TECHNOLOGIES Lifelong Learning Performance Competences HEALTH COSTS THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

5. Introduction eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey general hypothesis costs vary according to the training of health professionals involved in the diagnosis and treatment of chronic wounds. THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

6. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey Web Based Learning (e-fer) THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

8. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey Mathematical model to estimate the costs of chronic wounds THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

9. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey

10. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey ETT – Expected Treatment Time (weeks)

11. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey DCW – Dressing Costs per Week

12. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey LCW –Labour (nursing) Costs per Week

13. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey TChs – Travel costs from patient home to Health Service – per week TCph – Travel costs from Health Service to patient home – per week

14. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey CE – Costs of Equipment for pressure relieving support

15. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey PLF – Productivity losses by familiar that support patient. PLP – Productivity losses by patient (if the patient is a worker)

16. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey Web Based System (e-fer Simulator) THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

18. Materials and methods eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey Optimum Cost matrices …by applying the mathematical model to the virtual cases validated. Cost of Decision matrices …by applying the mathematical model to the options chosen by the users in the e-fer Simulator THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

19. eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

20. eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

21. eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

22. eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

23. eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

24. Results eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey The results were analysed with the Mann-Whitney and Wilcoxon nonparametric test, with 95% confidence interval. The results reflect the difference between Optimum Costs and the Costs of Decision observed in the groups. THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

25. Results eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey The groups were homogeneous with regard to the Cost of Decision in the pre-test (U = 64; p= 0.641) Total Costs Pre test THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

26. Results eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey Difference between Optimal Costs and Costs of Decision observed in Groups (before and after training) Z= -3.059 p= 0.002 Z= -0,314 p= 0.753 Total Costs Pos test Pos test Pre test Pre test THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

27. Results eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey Control Group non-training costs (890.07 € for each wound) Experimental Group Cost of decision 119.19% above the OC Cost of decision 58.90% above the OC Optimum cost THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

28. Results eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey (salary losses of patient and/or familiar)428.08 € Indirect costs (428.08 €) 48% non-training costs (890.07 € for each wound) (nurse’s salaries and travel expenses) 196.90 € 22% direct costs (461.99 €) (patient’s travel expenses) 171.28 € 19% (dressing materials) 97.09 € 11% THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

29. Conclusion eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey How mutch € can we save through training ? economic burden healthcares THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

30. Conclusion eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

31. Conclusion eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

32. Conclusion eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

33. Conclusion eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation

34. eHealth 2009 - Second International ICST Conference on Electronic Healthcare for the 21st century Istanbul, Turkey THE COSTS OF NON-TRAINING IN CHRONIC WOUNDS: Estimates through practice simulation thank you for your attention Pedro Gaspar1 Josep Monguet2 Jordi Ojeda2 João Costa1 Rogério Costa1 1Polytechnic Institute of Leiria (IPL) - Portugal 2Polytechnic University of Catalonia (UPC) - Spain