Treatment of Patients With Severe Burns—Costs and Health-Related Quality of Life Outcome

Abstract

To study the effectiveness of the treatment of patients with severe burns, the authors collected health-related quality of life (HRQoL) data with the 15D instrument, 17 to 29 months after treatment had commenced at the national burns unit. The costs of each patient's secondary care treatment were followed for a mean of 66 months. During the 1-year study period, 107 patients were treated at the burns unit, eight for scar surgery, the remainder for primary treatment of a burn injury; 19 had died or could not be located during the time of the HRQoL survey. Of the remaining 88 patients, 43 (49%; mean [SD] age 45.7 [14.8] years; 70% men) returned the questionnaire. Their mean (SD) HRQoL score (0.909[0.113]) was only slightly, and not significantly, lower than that of the age- and sex- standardized general population (0.928[0.080]). The mean (SD) secondary care cost of burn treatment of for all the 107 patients, over the 60- to 72-month observation time, was 42,838 USD (73,569 USD; range 1319-34,8741 USD). The largest portion of the total cost was because of inpatient treatment (61%) followed by operations (22%), and outpatient visits. In addition to the costs of burns treatment, the patients consumed other secondary care services to a value of nearly 12,229 USD. The HRQoL in patients treated for severe burns is good, thus the observed high-treatment costs can be considered acceptable.

The long-term health-related quality of life in children treated for burns as infants 5–9 years earlier

“…The perceived HRQoL observed in this study is in line with previous results on adult burn survivors treated in Helsinki Burn Center of the Helsinki University Hospital, Finland [34,37]. Yet, the good overall HRQoL of the patients and the fact that on some dimensions of the 17D instrument patients fared statistically significantly better that the control population, was somewhat surprising.…”

“…Accordingly it seems that the etiology of the burn has little or no effect on the HRQoL in this patient group. In adult burn survivors, the etiology of the burn has an effect on the HRQoL, as we have shown previously [33]. Respondents in this study who were treated as outpatients had minor burns and also fared better compared to those who needed inpatient treatment.…”

Health-related quality of life 6 months after burns among hospitalized patients: Predictive importance of mental disorders and burn severity

“…As a new instrument in burn literature, 15D is an important supplement to HRQoL measures of burn patients, despite only being used in one earlier study, yielding two publications [21,22], in our burn centre. In comparison of 15D with other measures used among burn patients, such as SF-36 and EQ-5D, limitations of both SF-36 and EQ-5D have been described; e.g.…”

“…The 15D can be used as a singleindex (from 0 to 1) health utility measure, like the EQ-5D, or as a profile. It has recently been successfully used also in HRQoL evaluation of hospitalized burn patients in a prospective study in the Helsinki Burn Centre, Finland [21][22][23]. EQ-5D and 15D have been compared as HRQoL measures in the Finnish nationwide Health 2000 study among the general adult population [24,25].…”

Two-year follow-up of outcomes related to scarring and distress in children with severe burns

“…Although burn injury mortality rates have decreased [2], improving the quality of life after a burn injury remains challenging [3]. Redirecting the focus beyond patient survival, towards maximizing rehabilitation and the quality of life after injury is of increasing importance [4].…”