Are labour-intensive efforts to prevent pressure ulcers cost-effective?

Pressure ulcers are a major problem in Danish healthcare with a prevalence of 13-43% among hospitalized patients. The associated costs to the Danish Health Care Sector are estimated to be €174.5 million annually. In 2010, The Danish Society for Patient Safety introduced the Pressure Ulcer Bundle (PU...

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Bibliographic Details
Published in:	Journal of medical economics Vol. 16; no. 10; p. 1238
Main Authors:	Mathiesen, Anne Sofie Mølbak, Nørgaard, Kamilla, Andersen, Marie Frederikke Bruun, Møller, Klaus Meyer, Ehlers, Lars Holger
Format:	Journal Article
Language:	English
Published:	England 01-10-2013
Subjects:	Community Health Nursing - economics Cost-Benefit Analysis Cross Infection - economics Cross Infection - epidemiology Cross Infection - prevention & control Decision Support Techniques Decision Trees Denmark - epidemiology Economics, Hospital Health Care Costs - statistics & numerical data Home Care Services - economics Humans Incidence Inpatients - statistics & numerical data Long-Term Care - economics Patient Discharge - economics Patient Discharge - statistics & numerical data Pressure Ulcer - economics Pressure Ulcer - epidemiology Pressure Ulcer - prevention & control Prevalence Probability Standard of Care - economics Time Factors Denmark
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Summary:	Pressure ulcers are a major problem in Danish healthcare with a prevalence of 13-43% among hospitalized patients. The associated costs to the Danish Health Care Sector are estimated to be €174.5 million annually. In 2010, The Danish Society for Patient Safety introduced the Pressure Ulcer Bundle (PUB) in order to reduce hospital-acquired pressure ulcers by a minimum of 50% in five hospitals. The PUB consists of evidence-based preventive initiatives implemented by ward staff using the Model for Improvement. To investigate the cost-effectiveness of labour-intensive efforts to reduce pressure ulcers in the Danish Health Care Sector, comparing the PUB with standard care. A decision analytic model was constructed to assess the costs and consequences of hospital-acquired pressure ulcers during an average hospital admission in Denmark. The model inputs were based on a systematic review of clinical efficacy data combined with local cost and effectiveness data from the Thy-Mors Hospital, Denmark. A probabilistic sensitivity analysis (PSA) was conducted to assess the uncertainty. Prevention of hospital-acquired pressure ulcers by implementing labour-intensive effects according to the PUB was cost-saving and resulted in an improved effect compared to standard care. The incremental cost of the PUB was -€38.62. The incremental effects were a reduction of 9.3% prevented pressure ulcers and 0.47% prevented deaths. The PSAs confirmed the incremental cost-effectiveness ratio (ICER)'s dominance for both prevented pressure ulcers and saved lives with the PUB. This study shows that labour-intensive efforts to reduce pressure ulcers on hospital wards can be cost-effective and lead to savings in total costs of hospital and social care. The data included in the study regarding costs and effects of the PUB in Denmark were based on preliminary findings from a pilot study at Thy-Mors Hospital and literature.
ISSN:	1941-837X
DOI:	10.3111/13696998.2013.832256