Mezzalira Elisabetta, Ambrosi Elisa, Askew Neil, Nherera Leo, Searle Richard, Fatoye Francis, Forni Cristiana
Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Smith and Nephew, Fort Worth, TX, USA.
Int J Health Policy Manag. 2024 Nov 10;13. doi: 10.34172/ijhpm.8371.
Hospital-acquired pressure ulcers (HAPUs) constitute an important source of concern for healthcare systems due to their negative consequences on patient quality of life and hospital costs. This phenomenon is increasing worldwide, driven by an aging population and increasing prevalence of chronic conditions. This economic evaluation aimed to determine whether using a multilayer, silicone-adhesive polyurethane foam dressing shaped for the sacrum area, alongside standard prevention (SP), is cost-effective in preventing HAPUs for hospitalized patients compared to SP alone.
We developed a decision-analytic model to estimate the expected costs and clinical benefits of using the polyurethane foam dressing from Italian and US payor perspectives. Model inputs were taken from published studies, and uncertainty was assessed using one-way and probabilistic sensitivity analyses (PSA).
From both US and Italian perspectives, using a foam dressing in addition to SP was found to be cost-saving in all hospital settings. That is, it reduced the incidence of HAPUs at a lower cost overall. The estimated savings were €179 per patient and $305 per patient from Italian and US perspectives. Following sensitivity analysis, the results remained cost-saving, suggesting that our findings are robust.
This is the first economic analysis investigating the cost-effectiveness of preventive dressings and standard prevention for avoiding sacral pressure ulcers for at-risk hospitalized patients. This analysis suggests that using a multilayer polyurethane foam dressing to prevent sacral HAPUs in at-risk hospitalized patients is a cost-effective strategy compared with standard prevention alone and, therefore, should be considered as a strategy for PU prevention in hospital settings.
医院获得性压疮（HAPUs）因其对患者生活质量和医院成本产生负面影响，成为医疗系统关注的重要问题。受人口老龄化和慢性病患病率上升的推动，这一现象在全球范围内呈上升趋势。本经济评估旨在确定，与仅采用标准预防措施（SP）相比，使用专为骶骨区域设计的多层硅胶粘性聚氨酯泡沫敷料并结合标准预防措施，在预防住院患者发生医院获得性压疮方面是否具有成本效益。
我们建立了一个决策分析模型，从意大利和美国付款人的角度估计使用聚氨酯泡沫敷料的预期成本和临床效益。模型输入数据来自已发表的研究，并使用单向和概率敏感性分析（PSA）评估不确定性。
从美国和意大利的角度来看，在所有医院环境中，除标准预防措施外使用泡沫敷料都能节省成本。也就是说，它以更低的总成本降低了医院获得性压疮的发生率。从意大利和美国的角度估计，每位患者可节省179欧元和305美元。经过敏感性分析，结果仍然显示节省成本，这表明我们的研究结果具有稳健性。
这是第一项关于预防性敷料和标准预防措施在预防高危住院患者骶骨压疮方面成本效益的经济分析。该分析表明，与仅采用标准预防措施相比，使用多层聚氨酯泡沫敷料预防高危住院患者的骶骨医院获得性压疮是一种具有成本效益的策略，因此，应被视为医院环境中预防压疮的一种策略。
