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The medical vacuum device — sorry, the “negative pressure wound therapy unit” — looks pretty much like a bunch of hard plastic and a couple of bendable tubes.
It’s about the size of a hardcover book and hangs around the neck in a pouch. But it has magical powers, amputee Paul Pelletier told me earlier this month. It works by sealing the wound area, packing the cavity with a special sponge and draining away fluids into a canister.
The “negative pressure” also helps the skin draw out and stitch together properly, reducing the risk of infection and, in Pelletier’s case, further diabetic-caused amputations.
But imagine this: it costs more than $20,000 in public funds to buy or close to $90 a day to rent, which is pretty kooky economics. (For $2,700 a month, one could rent a house and car, no?)
Here’s why this matters: increasingly, health care is being delivered in our homes, because it’s a more healing environment, it’s cheaper than a hospital, and because equipment is becoming more portable.
Consider that The Ottawa Hospital, at three campuses, has 1,100 hospital beds, but our Community Care Access Centre attends to 20,000 patients a month. The CCAC, by the way, does not have enough so-called VAC units, which led to the agency telling Pelletier, 51, he would have to return his pump after he hit the 10-week limit.
It did not seem to matter that his wound had yet to heal. In any case, many readers wondered, why couldn’t the CCAC simply turn around and buy another pump?
Well, because it’s $20,000-plus.
Both Pelletier and I marvelled at how a little bit of plastic, a small pump, some sensors and some tubing could cost as much as a compact car.
You can now take chemo and dialysis at home, and Lord knows what else. So we arrive at the dilemma. As we deliver more and more care at home, with more and more portable equipment, how are we going to afford it all? And is there a better way?
Stick with the vacuum pump for a second. Our CCAC, which has an annual budget of $240 million, owns about a dozen of these pumps and rents another 28, for a total cap of 40. It isn’t enough. The centre has a waiting list of between 15 and 25, more or less all the time.
“We’ve got a demand for services — for every single service that we have — increasing at an unprecedented rate,” said Catherine Butler, vice-president of clinical care at the Champlain CCAC, which spends about $15 million annually on medical equipment and lab work.
The average time the units are used is 40 days, or $3,600 at the private charge-out rate. If those numbers seem a little off-base, I’m right there with you: the machine seals and sucks, how could it cost this much?
The big player in the negative pressure market is a company called KCI, based in Texas but with operations around the world. Its technology is proprietary and patent-protection prevented other companies from simply making cheaper knockoffs. So the CCAC, in essence, was stuck buying or renting a $20,000 pump.
Enter Medela, a Swiss-based multinational best known for its breast pumps. It has a different approach. Instead of making a high-horsepower machine at $20K — one that has to be tracked with the patient, returned, then cleaned, serviced, sent out again with new parts — why not a cheaper, disposable version?
The company has developed two “personal” models that are smaller and programmed to work for 15 or 60 days, at which point they are thrown out. Cost? $750 for the 15-day model and about $1,500 for the 60.
All these devices, in theory, do the same thing. How a $750 disposable unit can duplicate the work of a $20,000 reusable model is one of those instances of voodoo economics that make health spending so impenetrable.
“I do think there is an opportunity to reduce some of the expense in the health care system,” says Steve McCormack, Medela Canada Inc.’s managing director.
“I know the Ministry of Health and the CCAC are working hard to figure this whole situation out.”
If only to make the situation a little more complicated, the CCAC gets its supplies from pre-approved vendors. The Medela negative pressure units, meanwhile, are not among those carried by the supplier.
“It’s a big machinery,” says McCormack. “But we’re patient. We think we have a great solution from the health-care economics side of it as well as the patient side of it.”
Pelletier, meanwhile, is recovering just fine, about the only part of this saga easy to follow.
To contact Kelly Egan, please call 613-726-5896 or email kegan@postmedia.com
Twitter.com/kellyegancolumn
查看原文...
It’s about the size of a hardcover book and hangs around the neck in a pouch. But it has magical powers, amputee Paul Pelletier told me earlier this month. It works by sealing the wound area, packing the cavity with a special sponge and draining away fluids into a canister.
The “negative pressure” also helps the skin draw out and stitch together properly, reducing the risk of infection and, in Pelletier’s case, further diabetic-caused amputations.
But imagine this: it costs more than $20,000 in public funds to buy or close to $90 a day to rent, which is pretty kooky economics. (For $2,700 a month, one could rent a house and car, no?)
Here’s why this matters: increasingly, health care is being delivered in our homes, because it’s a more healing environment, it’s cheaper than a hospital, and because equipment is becoming more portable.
Consider that The Ottawa Hospital, at three campuses, has 1,100 hospital beds, but our Community Care Access Centre attends to 20,000 patients a month. The CCAC, by the way, does not have enough so-called VAC units, which led to the agency telling Pelletier, 51, he would have to return his pump after he hit the 10-week limit.
It did not seem to matter that his wound had yet to heal. In any case, many readers wondered, why couldn’t the CCAC simply turn around and buy another pump?
Well, because it’s $20,000-plus.
Both Pelletier and I marvelled at how a little bit of plastic, a small pump, some sensors and some tubing could cost as much as a compact car.
You can now take chemo and dialysis at home, and Lord knows what else. So we arrive at the dilemma. As we deliver more and more care at home, with more and more portable equipment, how are we going to afford it all? And is there a better way?
Stick with the vacuum pump for a second. Our CCAC, which has an annual budget of $240 million, owns about a dozen of these pumps and rents another 28, for a total cap of 40. It isn’t enough. The centre has a waiting list of between 15 and 25, more or less all the time.
“We’ve got a demand for services — for every single service that we have — increasing at an unprecedented rate,” said Catherine Butler, vice-president of clinical care at the Champlain CCAC, which spends about $15 million annually on medical equipment and lab work.
The average time the units are used is 40 days, or $3,600 at the private charge-out rate. If those numbers seem a little off-base, I’m right there with you: the machine seals and sucks, how could it cost this much?
The big player in the negative pressure market is a company called KCI, based in Texas but with operations around the world. Its technology is proprietary and patent-protection prevented other companies from simply making cheaper knockoffs. So the CCAC, in essence, was stuck buying or renting a $20,000 pump.
Enter Medela, a Swiss-based multinational best known for its breast pumps. It has a different approach. Instead of making a high-horsepower machine at $20K — one that has to be tracked with the patient, returned, then cleaned, serviced, sent out again with new parts — why not a cheaper, disposable version?
The company has developed two “personal” models that are smaller and programmed to work for 15 or 60 days, at which point they are thrown out. Cost? $750 for the 15-day model and about $1,500 for the 60.
All these devices, in theory, do the same thing. How a $750 disposable unit can duplicate the work of a $20,000 reusable model is one of those instances of voodoo economics that make health spending so impenetrable.
“I do think there is an opportunity to reduce some of the expense in the health care system,” says Steve McCormack, Medela Canada Inc.’s managing director.
“I know the Ministry of Health and the CCAC are working hard to figure this whole situation out.”
If only to make the situation a little more complicated, the CCAC gets its supplies from pre-approved vendors. The Medela negative pressure units, meanwhile, are not among those carried by the supplier.
“It’s a big machinery,” says McCormack. “But we’re patient. We think we have a great solution from the health-care economics side of it as well as the patient side of it.”
Pelletier, meanwhile, is recovering just fine, about the only part of this saga easy to follow.
To contact Kelly Egan, please call 613-726-5896 or email kegan@postmedia.com
Twitter.com/kellyegancolumn
查看原文...
