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Cost-utility analysis applied to the treatment of burn patients in a specialized center
José-Luis Alfonso Sánchez1, Sergio Blasco Perepérez, Julio López Bastida
1Department of Preventive Medicine and Public Health, University of Valencia, Avenida Tres Cruces No. 2, 46014 Valencia, Spain. jose.l.alfonso@uv.es
Objective:
To discover the total costs and quality of life of burn patients in a specialist center classified by diagnosis-related groups (DRGs).
Design:
Prospective study of 5-year follow-up from January 1, 1997, through December 31, 2001.
Setting:
Burn Center of Valencia.
Patients:
A total of 898 patients treated at the Burn Center of Valencia.
Main Outcome Measures:
Hospital, extrahospital, caregiving, labor, and social costs of the burn patients grouped by DRG (code 457: extensive burns without operating room procedure; code 458: nonextensive burns with skin graft; code 459: nonextensive burns with wound debridement or other operating room procedure; code 460: nonextensive burns without operating room procedure; or code 472: extensive burns with operating room procedure) were studied. The costs were compared with those that the DRG system assigns. The quality of life of the patients at the end of the follow-up period was also studied. To measure quality of life, the EuroQol 5-Dimensions survey was used. Utility calculations and cost-utility analysis were undertaken according to life expectancy.
Results:
The number of quality-adjusted life-years produced by the center was 13 577, with a mean quality-of-life level on release from the study of 0.87. The mean cost per patient, including the social and labor costs, was $95 551, with health care costs amounting to only 10%. The mean cost per quality-adjusted life-year was $686.
Conclusions:
The labor costs were the most important and amounted to 56%; together with the social costs, these constituted 85% of the total costs. The DRG code 456 was an option dominated by the remaining DRG codes 458 through 460 and 472. Given the high costs of treating burn patients, a clear health care policy is urgently needed.
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