Quality and cost-effectiveness—Effects in burn care

Mandal, Anirban

doi:10.1016/j.burns.2006.08.035

Cited by 36 publications

(38 citation statements)

References 25 publications

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“…Burn care is undeniably expensive and arguably has one of the highest financial costs in pediatric health care, yet limited health economic research has been conducted in the burns arena. External financial pressures on health care budgets create much deliberation and contentious debates over balancing quality health care versus less costly service delivery [2]. There is a great need for health research to extend beyond providing evidence of one practice being more effective than another.…”

Section: Introductionmentioning

confidence: 98%

Cost-Effectiveness of a Nonpharmacological Intervention in Pediatric Burn Care

et al. 2015

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Section: Introductionmentioning

confidence: 98%

Cost-Effectiveness of a Nonpharmacological Intervention in Pediatric Burn Care

et al. 2015

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“…This problem has prompted many researchers to seek ways to make burn care more cost-effective. 13,14 Even though specific data about the cost-effectiveness of burn centers is still somewhat lacking, the ABA's board of trustees has declared during the deliberations of the committee on organizing and delivery of burn care that burn center care is the most efficient and cost-effective care for burn injuries. 15 A larger burn center in Israel may convey lower mortality rates.…”

Section: Discussionmentioning

confidence: 99%

Examining National Burn Care Policies—Is the Israeli Burn Care Alignment Based on National Data?

Haik

Weissman

Givon

et al. 2012

Journal of Burn Care & Research

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The treatment of burn victims constitutes a considerable challenge both to the clinician in regard to mundane treatment and to health systems in regard to structural organization. The state of Israel is in dire need of competent burn care capabilities for political, geographical, and demographic reasons. Israel currently has five designated burn units but no burn center. A review of the recent literature suggests that larger burn centers can convey lower mortality rates and better functional outcomes for severe burn patients in comparison to smaller burn units. The objective of this study is to assess Israel's burn care alignment needs and capabilities based on Israel's burn patient and burn unit data. In addition, the authors aim to compare the burn care alignment capabilities with those of the country's European and American counterparts. Data of all the burn patients hospitalized in Israel's level 1 trauma centers' burn units between the years 1998 and 2005 according to the Israeli Trauma Registry were analyzed. Simultaneously, data regarding the setup and arrangement of each burn unit were obtained from each burn unit director via phone. Between the years 1998 and 2005, 974 adult patients with burns of the second degree or higher spanning 20% TBSA and more were hospitalized in the five hospitals that operate a functional specialized burn unit. The average hospitalization period was 32.4 days while the mortality rate was 21.1%. Currently, Israel's five burn units report possessing 27 burn beds and 14 burn intensive care unit beds. Due to the continuous risk for terror attacks and military campaigns and due to Israel's inability to refer excess burn patients to neighboring countries, Israel desperately needs efficient burn care capabilities. Israel currently trails both the United States and Europe in regard to burn beds and burn centers per population. The annual quantity and severity of burn patients in Israel largely exceeds the amount needed to justify an establishment of a burn center by the current American Burn Association guidelines, while the literature provides vast amount of evidence proving burn centers' efficacy in improving outcome, shortening hospitalization periods, and reducing costs. Taking all these elements into consideration, it might be prudent to establish a national burn center in Israel to promote burn care standards and disaster planning up to international standards.

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“…3 While the treatment of most superficial and deep burns is usually clear, more options exist for mid-dermal burns. 14 Depending on the burn center, practices can be geared toward more aggressive early excision or may have a preference for conservative management followed by operative if required after follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Health care professionals are being required to justify costs in the current environment of limited resources and the expectation that funds be used efficiently. [2][3][4][5][6] The Royal College of Physicians and Surgeons of Canada has advocated the role of "Manager" as a role for specialists and includes the wise allocation of finite health care resources. 7 Even the popular media has drawn attention to the importance of the wise use of limited health care resources.…”

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confidence: 99%

Reduced Length of Stay in Hospital for Burn Patients Following a Change in Practice Guidelines

Jansen

Hynes

Macadam

et al. 2012

Journal of Burn Care & Research

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The objective of this study was to analyze the financial implications of the implementation of new institutional practice guidelines including greater outpatient care and earlier operative intervention in a provincial burn center. A retrospective review was performed including all patients admitted to the Burn Unit with burns up to 20% TBSA between August 2005 and July 2009, including 2 years before and after the new guidelines were introduced. Daily costs for the burn unit were used to calculate this portion of cost. Length of stay (LOS) was based on actual data and representative clinical scenarios. Two hundred sixty-four patients were included. Mean LOS decreased from 10.3 to 3.9 (P < .01) and 21.0 to 13.3 (P > .05) for nonoperative burns 0 to 10% and 10 to 20% TBSA, respectively. Mean LOS for operative burns decreased from 16.6 to 12.9 and 32.3 to 29.8 days for 0 to 10% and 10 to 20% TBSA, respectively (P > .05). Burn patient management requires significant financial resources, and LOS has a large impact on cost. Given per diem rates of Can$1,663, scenario analysis shows potential cost savings of Can$19,956 per patient for operative and nonoperative burns <20% TBSA. With an average of 66 such patients treated each year, potential annual cost savings are Can$1.3 million. If outcomes are not compromised, earlier operative management and greater outpatient care can translate into significant cost savings. A prospective analysis capturing all costs and patient quality of life is required for further assessment.

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Quality and cost-effectiveness—Effects in burn care

Cited by 36 publications

References 25 publications

Cost-Effectiveness of a Nonpharmacological Intervention in Pediatric Burn Care

Cost-Effectiveness of a Nonpharmacological Intervention in Pediatric Burn Care

Examining National Burn Care Policies—Is the Israeli Burn Care Alignment Based on National Data?

Reduced Length of Stay in Hospital for Burn Patients Following a Change in Practice Guidelines

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