High cost of stage IV pressure ulcers.

BACKGROUND The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. METHODS A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and analyzed. Costs directly related to the treatment of pressure ulcers and their associated complications were calculated. RESULTS Nineteen patients with stage IV pressure ulcers (11 hospital-acquired and 8 community-acquired) were identified and their charts were reviewed. The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during 1 admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. CONCLUSIONS The costs incurred from stage IV pressure ulcers are much greater than previously estimated. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce health care expenditures by millions of dollars.

[1]  T. Einarson,et al.  Direct Health Care Costs of 4 Common Skin Ulcers in New Mexico Medicaid Fee-for-Service Patients , 2004, Advances in skin & wound care.

[2]  J. Milbrandt,et al.  Healing Pressure Ulcers with Collagen or Hydrocolloid: A Randomized, Controlled Trial , 2003, Journal of the American Geriatrics Society.

[3]  J. Lowery,et al.  Assessing Persistent Pain and Its Relation to Affective Distress, Depressive Symptoms, and Pain Catastrophizing in Patients with Chronic Wounds: A Pilot Study , 2004, American journal of physical medicine & rehabilitation.

[4]  C. Moffatt,et al.  Health‐related quality of life and pressure ulceration assessment in patients treated in the community , 2002, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[5]  M. Meehan.  Beyond the pressure ulcer blame game: reflections for the future. , 2000, Ostomy/wound management.

[6]  Jane Nixon,et al.  Pressure relieving support surfaces (PRESSURE) trial: cost effectiveness analysis , 2006, BMJ : British Medical Journal.

[7]  S. Kurata,et al.  Gas Gangrene Following Sacral Pressure Sores , 1994, The Journal of dermatology.

[8]  L. Téot,et al.  Evaluation of a silver-releasing hydroalginate dressing in chronic wounds with signs of local infection. , 2005, Journal of wound care.

[9]  J. Fallon,et al.  Molecular pathogenesis of chronic wounds: the role of beta-catenin and c-myc in the inhibition of epithelialization and wound healing. , 2005, The American journal of pathology.

[10]  Michael S. Golinko,et al.  Standardization of Wound Photography Using the Wound Electronic Medical Record , 2009, Advances in skin & wound care.

[11]  Nancy Bergstrom,et al.  The National Pressure Ulcer Long‐Term Care Study: Outcomes of Pressure Ulcer Treatments in Long‐Term Care , 2005, Journal of the American Geriatrics Society.

[12]  L. Napolitano,et al.  Necrotizing Soft Tissue Infection From Decubitus Ulcer After Spinal Cord Injury , 2004, Spine.

[13]  Dirk De Bacquer,et al.  The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers. , 2005, International journal of nursing studies.

[14]  F. Sorvillo,et al.  Pressure Ulcers: More Lethal Than We Thought? , 2005, Advances in skin & wound care.

[15]  C. Lyder,et al.  A comprehensive program to prevent pressure ulcers in long-term care: exploring costs and outcomes. , 2002, Ostomy/wound management.

[16]  R. Allman,et al.  Pressure ulcers, hospital complications, and disease severity: impact on hospital costs and length of stay. , 1999, Advances in wound care : the journal for prevention and healing.

[17]  Susan L Garber,et al.  Pressure ulcers in veterans with spinal cord injury: a retrospective study. , 2003, Journal of rehabilitation research and development.

[18]  E. M. DeVito,et al.  The Increasing Medical Malpractice Risk Related to Pressure Ulcers in the United States , 2000, Journal of the American Geriatrics Society.

[19]  C. Steiner,et al.  Hospitalizations Related to Pressure Ulcers Among Adults 18 Years and Older, 2006 , 2008 .

[20]  W L Miller,et al.  The 1999 National Pressure Ulcer Prevalence Survey: a benchmarking approach. , 2001, Advances in skin & wound care.

[21]  V. L. Lewis,et al.  The Value of Jamshidi Core Needle Bone Biopsy in Predicting Postoperative Osteomyelitis in Grade IV Pressure Ulcer Patients , 2002, Plastic and reconstructive surgery.

[22]  R. Halfens,et al.  Differences in prevalence of pressure ulcers between the Netherlands and Germany--associations between risk, prevention and occurrence of pressure ulcers in hospitals and nursing homes. , 2008, Journal of clinical nursing.

[23]  M. Molinari,et al.  Pressure sores and blood and serum dysmetabolism in spinal cord injury patients , 2004, Spinal Cord.

[24]  G. Rodeheaver,et al.  Guidelines for the treatment of pressure ulcers , 2006, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[25]  D. M. Cooper,et al.  Definitions and guidelines for assessment of wounds and evaluation of healing , 1994, Archives of dermatology.

[26]  H. Brem,et al.  Protocol for the successful treatment of pressure ulcers. , 2004, American journal of surgery.

[27]  M. Kerstein.  Unexpected Economics of Ulcer Care Protocols , 2004, Southern medical journal.

[28]  A Hartz,et al.  Improvement in Resource Utilization after Development of a Clinical Pathway for Patients with Pressure Ulcers , 1998, Plastic and reconstructive surgery.

[29]  V. Gahtan,et al.  What is the Paradigm: Hospital or Home Health Care for Pressure Ulcers ? , 1999, The American surgeon.

[30]  F. Rivara,et al.  Incidence and Characteristics of Hospitalized Patients with Pressure Ulcers: State of Washington, 1987 to 2000 , 2006, Plastic and reconstructive surgery.

[31]  D. M. Cooper,et al.  Definitions and guidelines for assessment of wounds and evaluation of healing. , 1994, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.