Costs of burn care: A systematic review

Abstract

Burn care is traditionally considered expensive care. However, detailed information about the costs of burn care is scarce despite the increased need for this information and the enhanced focus on healthcare cost control. In this study, economic literature on burn care was systematically reviewed to examine the problem of burn-related costs. Cost or economic evaluation studies on burn care that had been published in international peer-reviewed journals from 1950 to 2012 were identified. The methodology of these articles was critically appraised by two reviewers, and cost results were extracted. A total of 156 studies met the inclusion criteria. Nearly all of the studies were cost studies (n = 153) with a healthcare perspective (n = 139) from high-income countries (n = 127). Hospital charges were often used as a proxy for costs (n = 44). Three studies were cost-effectiveness analyses. The mean total healthcare cost per burn patient in high-income countries was $88,218 (range $704-$717,306; median $44,024). A wide variety of methodological approaches and cost prices was found. We recommend that cost studies and economic evaluations employ a standard approach to improve the quality and harmonization of economic evaluation studies, optimize comparability, and improve insight into burn care costs and efficiency.

Cost Analysis of 48 Burn Patients in a Mass Casualty Explosion Treated at Chang Gung Memorial Hospital

“…This result is consistent with previous cost studies that have examined the economic management of typical burn populations 2,5 . In our study, we found that for each day added to a patient’s stay, the patient care and facility fees included in this category contributed the largest additional proportion to overall costs.…”

“…As a result, the patients injured in the Taiwan event required increased and prolonged use of variable antibiotics and antifungal agents, and experienced additional waiting time for artificial skin substitutes to become available. Because of this, medication fees became a higher cost driver in this patient cohort compared to the cohorts in previous burn studies 2,6,16 .…”

“…Previous cost studies have noted surgery 2 and artificial dressing materials 6,16 as the expensive components of burn care. In this study, the high medication cost category may have resulted owing to the unique nature of mass casualty burn care.…”

“…Compared to other forms of trauma, burns are one of the most costly injuries for health care systems 2 . Burn patients require prolonged hospitalization, extensive numbers of treatment sessions, and often undergo multiple surgical procedures 3 .…”

“…Given the intensive resources necessary for treating these patients, advance preparation becomes crucial to saving more lives 7 . Cost studies remain an important tool in promoting this anticipated resource allocation, and also in developing specific cost-reduction strategies for the treatments consumed 2 .…”