The national cost of hospital‐acquired pressure injuries in the United States

International Wound Journal - Tập 16 Số 3 - Trang 634-640 - 2019
William V. Padula1, Benjo A. Delarmente2
1Leonard D. Schaeffer Center for Health Policy and Economics, Department of Pharmaceutical and Health Economics, School of Pharmacy, University of Southern California, Los Angeles, California
2Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

Tóm tắt

Our objective was to estimate the US national cost burden of hospital‐acquired pressure injury (HAPI) using economic simulation methods. We created a Markov simulation to estimate costs for staged pressure injuries acquired during hospitalisation from the hospital perspective. The model analysed outcomes of hospitalised adults with acute illness in 1‐day cycles until all patients were terminated at the point of discharge or death. Simulations that developed a staged pressure injury after 4 days could advance from Stages 1 to 4 and accrue additional costs for Stages 3 and 4. We measured costs in 2016 US dollars representing the total cost of acute care attributable to HAPI incidence at the patient level and for the entire United States based on the previously reported epidemiology of pressure injury. US HAPI costs could exceed $26.8 billion. About 59% of these costs are disproportionately attributable to a small rate of Stages 3 and 4 full‐thickness wounds, which occupy clinician time and hospital resources. HAPIs remain a concern with regard to hospital quality in addition to being a major source of economic burden on the US health care system. Hospitals should invest more in quality improvement of early detection and care for pressure injury to avoid higher costs.

Từ khóa


Tài liệu tham khảo

10.1016/S1553-7250(07)33069-9

Berlowitz D, 2014, Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care

10.1097/WON.0000000000000050

10.1001/archinternmed.2011.473

10.1001/jama.2008.778

10.1097/WON.0000000000000292

Bauer K, 2016, Pressure ulcers in the United States' inpatient population from 2008 to 2012: results of a retrospective nationwide study, Ostomy Wound Manage, 62, 30

Hedegaard H, 2017, NHCS Data Brief

US Centers for Disease Control and Prevention. National violent death reporting system.https://www.cdc.gov/violenceprevention/nvdrs/index.html.2017. Accessed February 22 2018.

US Centers for Disease Control and Prevention. Estimating seasonal influenza‐associated deaths in the United States.https://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm.2018. Accessed February 22 2018.

10.1377/hlthaff.2011.0084

10.1016/j.amjsurg.2009.12.021

10.1016/j.jval.2017.07.007

Centers for Medicare and Medicaid Services. Eliminating serious preventable and costly medical errors ‐ never events.https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2006-Fact-Sheets-Items/2006-05-18.html.2006. Accessed February 22 2018.

Haesler E, 2014, Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline

Shreve J, 2010, The Economic Measurement of Medical Errors sponsored by the society of actuaries' health section

10.1097/MLR.0b013e31820292b3

10.1111/j.1742-481X.2009.00647.x

TreeAge Software, 2018, TreeAge Pro Healthcare 2018 user's manual

10.1001/jama.289.2.223

10.2165/00019053-199813040-00003

10.1097/WON.0000000000000281

10.1016/j.ijnurstu.2016.09.015

10.1016/j.ijnurstu.2017.02.022

Kaiser Family Foundation. Hospital adjusted expenses per inpatient day.https://www.kff.org/health-costs/state-indicator/expenses-per-inpatient-day/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22 %22sort%22:%22asc%22%7D.2017. Accessed February 22 2018.

10.1097/01.prs.0000197210.94131.39

10.1086/502542

10.1111/j.1532-5415.2012.04106.x

10.1097/PTS.0000000000000517

10.1111/j.1365-2702.2011.03915.x

10.1016/j.apnr.2014.07.001

10.1111/iwj.12160

10.4037/ajcc2016963

Padula WV, 2018, Value of hospital resources for effective pressure injury prevention: a cost‐effectiveness analysis, BMJ Qual Saf