The cost-effectiveness of sub-epidermal moisture scanning to assess pressure injury risk in U.S. health systems

Abstract

Objective Hospital-acquired pressure injuries harm over 2.5 million patients at a U.S. cost of $26.8 billion. Sub-epidermal moisture scanning technology supports clinicians to anatomically identify locations at-risk of developing hospital-acquired pressure injuries. Our objective was to evaluate the cost-effectiveness of adopting sub-epidermal moisture scanners in comparison to existing hospital-acquired pressure injury prevention guidelines structured around subjective risk assessments. Methods A Markov cohort model was developed to analyze the cost-effectiveness of sub-epidermal moisture scanners in comparison to existing prevention guidelines, based on current clinical trial data from the U.S. health care sector perspective in the acute, acute rehabilitation and skilled nursing facility settings. A hypothetical cohort was simulated over a time horizon of one year. An incremental cost-effectiveness ratio was measured using U.S. dollars per quality-adjusted life year at a willingness-to-pay threshold of $100,000/quality-adjusted life year, and uncertainty was tested using probabilistic sensitivity analysis. Results Integration of sub-epidermal moisture scanners yielded cost-savings of $4054 and 0.35 quality-adjusted life years gained per acute care admission, suggesting that sub-epidermal moisture scanners are a dominant strategy compared to standard care and producing a net monetary benefit of $39,335. For every 1000 admissions in high-risk acute care, sub-epidermal moisture scanners could avert around seven hospital-acquired pressure injury-related deaths and decrease hospital-acquired pressure injury-related re-hospitalization by approximately 206 bed-days. Conclusions Acute care, acute rehabilitation and skilled nursing settings that adopt sub-epidermal moisture technology could achieve a return on investment in less than one year. Providers may want to consider these types of technology that aid clinical judgment with objective measures of risk in quality improvement bundles.

Evaluating the sensitivity, specificity and clinical utility of algorithms of spatial variation in sub-epidermal moisture (SEM) for the diagnosis of deep and early-stage pressure-induced tissue damage

“…In the aggregate, results from this study in combination with laboratory studies, 14 inter-operator reliability studies, 19 damaged and healthy tissue studies, 26,49 longitudinal assessments 18 and other SEM studies 15,29,31,32,35,[50][51][52] through different tests of SEM have repeatedly shown that SEM is a predictor and a reliable indicator of the early onset of pressure-induced skin and tissue damage. Furthermore, a health economics analysis performed by Padula et al (2020), shows that prevention using the SEM test is cost-saving and is dominant in quality interventions when compared to the current standard of PI/PU care. 53 Certainly, prevention keeps the skin intact and the costs associated with treating broken skin and open wounds are intensive.…”

“…Furthermore, a health economics analysis performed by Padula et al (2020), shows that prevention using the SEM test is cost-saving and is dominant in quality interventions when compared to the current standard of PI/PU care. 53 Certainly, prevention keeps the skin intact and the costs associated with treating broken skin and open wounds are intensive.…”

Clinical profile of the SEM Scanner — Modernizing pressure injury care pathways using Sub-Epidermal Moisture (SEM) scanning

“…Deploying the SEM Scanner as an adjunct to routine PI care pathways results in significant PI incidence reductions. In multiple care settings, PI-related hospitalizations and subsequent high PI treatment costs are avoided resulting in the SEM Scanner being clinically more effective and less expensive than the current standard of care [50]. (QEF) [41].…”

Evaluating the impact on hospital acquired pressure injury/ulcer incidence in a United Kingdom NHS Acute Trust from use of sub‐epidermal scanning technology

“…Additional economic models indicate using the device in routine clinical practice as a dominant quality intervention, as it is more effective and less costly than the current SoC. In multiple care settings, highest per‐patient cost savings are realised due to large treatment costs avoided from later stage PI/PUs and PI/PU‐related hospitalisation (Padula et al, 2020).…”