Danish Center for Health Care Improvement, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University , Aalborg , Denmark.
J Med Econ. 2013 Oct;16(10):1238-45. doi: 10.3111/13696998.2013.832256. Epub 2013 Sep 6.
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.
在丹麦医疗保健中，压疮是一个主要问题，住院患者的患病率为 13-43%。据估计，丹麦医疗保健部门每年为此承担的费用高达 1.745 亿欧元。2010 年，丹麦患者安全协会推出了压疮包（PUB），旨在减少五家医院获得性压疮的发生率至少 50%。PUB 由病房工作人员使用改进模型实施的基于证据的预防措施组成。
研究丹麦医疗保健部门减少压疮的劳动密集型工作的成本效益，将 PUB 与标准护理进行比较。
构建了一个决策分析模型，以评估丹麦平均住院期间医院获得性压疮的成本和后果。该模型的输入基于对临床疗效数据的系统评价，结合丹麦 Thy-Mors 医院的当地成本和效果数据。进行概率敏感性分析（PSA）以评估不确定性。
根据 PUB 实施劳动密集型措施预防医院获得性压疮可节省成本，并与标准护理相比可提高效果。PUB 的增量成本为-38.62 欧元。增量效果为预防 9.3%的压疮和预防 0.47%的死亡。PSA 证实了 PUB 在预防压疮和挽救生命方面的增量成本效益比（ICER）具有优势。
这项研究表明，减少医院病房压疮的劳动密集型努力可以具有成本效益，并导致医院和社会护理总成本的节省。
本研究中关于 PUB 在丹麦的成本和效果的数据基于 Thy-Mors 医院的试点研究和文献中的初步发现。
