Modeling the economic losses from pressure ulcers among hospitalized patients in Australia

Graves, Nicholas; Birrell, Fraser; Whitby, Michael

doi:10.1111/j.1067-1927.2005.00066.x

Cited by 93 publications

(70 citation statements)

References 15 publications

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“…10 To incorporate uncertainty around the true prevalence, we fitted a beta distribution, which is suitable for parameters bounded by 0 and 1, using the minimum (0.2%) and maximum (17.6%) values reported in the Australian literature. 1,7,[32][33][34]38,39 The number of cases with PI was then calculated as the product of the estimated prevalence rate and the number of in-patient cases (discharges), sourced from Australian hospital statistics 2012-13. 43 …”

Section: Number Of Patients With Pi Casesmentioning

confidence: 99%

“…The treatment cost in Dealey et al 32 was estimated by the bottom-up costing method using 2011 data. It took into account daily resources for PI treatment, such as nursing time, special mattresses, dressings and medication.…”

Section: Average Treatment Cost Of Each Pi Stagementioning

confidence: 99%

“…In the literature, this value is approximated by 'willingness to pay' for those bed days. 32 Other societal costs, such as those related to lost productivity for carers or the intangible cost arising from reduced quality of life, were not included due to a lack of data that would support their valuation. 45 The calculation of the opportunity cost associated with lost bed days due to PI involved: (1) identifying the number of bed days wasted due to PI (extended LOS); (2) calculating average opportunity cost per bed day; and (3) estimating the total opportunity cost of extended bed days.…”

Section: Indirect Opportunity Costmentioning

confidence: 99%

“…Graves et al estimated the impact of PI on in-patient LOS, as well as the opportunity cost of bed days lost using 2001-02 data. 19,32 Jackson et al 33 reported that PI ranked among the top five hospital-acquired complications (by total additional system cost). Based on data from 2005-06 (Victoria) and 2006-07 (Queensland), Jackson et al reported the total number of PI cases to be 2873, representing a prevalence of 0.2% (much lower than the prevalence estimated in other studies 1,34,35 ) and a total cost of A$22.9 million for the public hospitals in these two states.…”

mentioning

confidence: 99%

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Pressure injury in Australian public hospitals: a cost-of-illness study

Nguyen

Chaboyer²,

Whitty

2015

Aust. Health Review

143

102

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Objective. Pressure injuries (PI) are largely preventable and can be viewed as an adverse outcome of a healthcare admission, yet they affect millions of people and consume billions of dollars in healthcare spending. The existing literature in Australia presents a patchy picture of the economic burden of PI on society and the health system. The aim of the present study was to provide a more comprehensive and updated picture of PI by state and severity using publicly available data.Methods. A cost-of-illness analysis was conducted using a prevalence approach and a 1-year time horizon based on data from the existing literature extrapolated using simulation methods to estimate the costs by PI severity and state subgroups.Results. The treatment cost across all states and severity in 2012-13 was estimated to be A$983 million per annum, representing approximately 1.9% of all public hospital expenditure or 0.6% of the public recurrent health expenditure. The opportunity cost was valued at an additional A$820 million per annum. These estimates were associated with a total number of 121 645 PI cases in 2012-13 and a total number of 524 661 bed days lost.Conclusions. The costs estimated in the present study highlight the economic waste for the Australian health system associated with a largely avoidable injury. Wastage can also be reduced by preventing moderate injuries (Stage I and II) from developing into severe cases (Stage III and IV), because the severe cases, accounting for 12% of cases, mounted to 30% of the total cost. What is known about the topic?The literature has identified that in the Australian health care system, wound management is one of the most frequently performed procedures. However, the overall economic cost of PI to the public hospital system is largely unknown. What does this paper add? This study provides reliable estimates, based predominantly on Australian data, of the number of cases and treatment costs associated with PI in public hospitals, disaggregated by state and severity. The paper also attempts to quantify the opportunity cost of PI, which leads to extra hospital length of stay. The estimated costs give an indication of the economic waste to the health system due to avoidable injury. What are the implications for practitioners? This study is relevant and important in the context of rising healthcare costs. It highlights an area for potential improvement in quality of care (i.e. better hospital experience for patients) and efficiency (i.e. reducing economic waste) in the hospital sector. It also reveals the paucity of data available to support cost estimation, from the prevalence and incidence rates to the treatment cost by disease severity, which further highlights an under-researched area.

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Section: Number Of Patients With Pi Casesmentioning

confidence: 99%

Section: Average Treatment Cost Of Each Pi Stagementioning

confidence: 99%

Section: Indirect Opportunity Costmentioning

confidence: 99%

mentioning

confidence: 99%

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Pressure injury in Australian public hospitals: a cost-of-illness study

Nguyen

Chaboyer²,

Whitty

2015

Aust. Health Review

143

102

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“…It has been estimated that in Australia, these injuries increase the length of hospital stay and subsequently incur $285 million in cost annually. 1 Since 2008, the Centers for Medicare and Medicaid Services no longer reimburses American hospitals at a higher rate for any pressure ulcer that occurs during a patient's hospitalization, which provides a strong financial stimulus for pressure ulcer prevention protocols to be implemented. 2 Indeed, the profound impact of pressure ulcers on the emotional, physical, mental, and social domains of life has been shown in different studies.…”

Section: Introductionmentioning

confidence: 99%

Pressure ulcer prevention and treatment: use of prophylactic dressings

Reid

Ayello²,

Alavi³

2016

CWCMR

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Abstract:The management of pressure ulcers is challenging for health care providers across disciplines. Pressure ulcers have significant impact on emotional and physical wellbeing, quality of life, and health care costs. The use of wound dressings could be an important and cost-effective strategy in preventing pressure ulcers. The main types of dressings that are examined for this purpose in the literature are foam, hydrocolloid, and films. Some small studies have shown a preventative role for sacral dressings with low-shear backings, though they raise concerns about over-hydration of the skin. Further research demonstrates the application of barrier films over bony prominences to have a prophylactic effect; however, adhesive dressings can also contribute to shearing forces on the skin. There is a vast body of research that examines the use of dressings to prevent pressure ulcers; however, there is limited high-level evidence, such as randomized control trials. A 2013 Cochrane review indicated that there is a paucity of high-level evidence to support the prophylactic use of dressings to prevent pressure ulcers; this paper will examine the emerging literature and consider its relevance to pressure ulcer prevention protocols.

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