前瞻性观察研究评估压疮成本面临的挑战：如何正确计价。

Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

J Wound Care. 2023 Sep 2;32(9):579-586. doi: 10.12968/jowc.2023.32.9.579.

OBJECTIVE

Pressure ulcers (PUs) are a significant healthcare problem with a negative impact on patients' quality of life and incurring substantial healthcare expenses. Our study aimed to analyse the costs of treating PUs in hospitalised patients in the Czech Republic, in the context of current treatment procedures and price levels, and to pilot-test the detailed methodology developed.

METHOD

A prospective, observational, non-interventional study was conducted at the Clinic of Anesthesiology, Resuscitation and Intensive Medicine, the Internal Medicine Department and the Surgical Department of the University Hospital Ostrava. The study included all hospitalised patients with a PU from March-May 2021. Data were collected using the hospital information system. A bottom-up, person-based approach to cost analysis was used, based on a comprehensive cost structure using accurate patient-specific consumption records.

RESULTS

The length of hospitalisations ranged from 1-31 (mean: 12.7) days. The average cost of PU treatment per hospitalisation was calculated at €1579. The average daily cost of PU treatment was €179, including antibiotic therapy (ATB) and €112 without ATB. Most of the costs were associated with ATB (38.6%) and caregivers' time (35.9%). Based on the results, a predictive model was developed to estimate the cost of treating a hospitalised patient with a PU, which could be used in future research to assess the costs of treating these patients.

CONCLUSION

We have faced many challenges in the methodology of preparation of cost analysis (e.g., how to count amorphous topical agents and sprays, how to properly identify PUs, how to price the positioning aids and mattresses, and how to relate the ATB treatment to the PU). This analysis provides important input for developing a comprehensive and more accurate methodology for monitoring PU costs in hospitalised patients, applicable in clinical practice for inpatient healthcare providers.

目的

压疮（PU）是一个严重的医疗保健问题，对患者的生活质量产生负面影响，并导致大量医疗保健费用。我们的研究旨在分析捷克共和国住院患者治疗压疮的成本，考虑到当前的治疗程序和价格水平，并对开发的详细方法进行试点测试。

方法

在奥斯特拉瓦大学医院的麻醉科、复苏和重症医学科、内科和外科进行了一项前瞻性、观察性、非干预性研究。该研究纳入了 2021 年 3 月至 5 月期间所有患有压疮的住院患者。数据通过医院信息系统收集。使用基于综合成本结构的基于个人的自下而上成本分析方法，基于准确的患者特定消费记录。

结果

住院时间从 1-31 天不等（平均：12.7 天）。每例住院患者的压疮治疗费用平均为 1579 欧元。压疮治疗的平均日费用为 179 欧元，包括抗生素治疗（ATB）和 112 欧元无 ATB。大部分费用与 ATB（38.6%）和护理人员时间（35.9%）有关。基于这些结果，开发了一种预测模型来估计治疗住院患者压疮的成本，该模型可用于未来的研究中，以评估治疗这些患者的成本。