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Preventing pressure ulcers in long-term care: a cost-effectiveness analysis
Ba' Pham1, Anita Stern, Wendong Chen
1TorontoHealth Economics and Technology Assessment Collaborative,Department of Health Policy Management andEvaluation, University of Toronto, 144 College Street, Toronto, Ontario, Canada. ba.pham@theta.utoronto.ca
Archives of Internal Medicine
|September 28, 2011
Summary
Implementing evidence-based strategies like pressure redistribution mattresses significantly reduces pressure ulcer risk and costs in long-term care. Foam cleansers and emollients also show cost-effectiveness, improving patient outcomes and quality of life.
Area of Science:
- Gerontology
- Health Economics
- Nursing Practice
Background:
- Pressure ulcers are a significant concern in long-term care, leading to poor health outcomes and high treatment expenses.
- Current prevention practices require evaluation for cost-effectiveness.
Purpose of the Study:
- To assess the cost-effectiveness of four evidence-based strategies for improving pressure ulcer prevention in long-term care facilities.
- To compare these strategies against current prevention practices.
Main Methods:
- A validated Markov model was employed to simulate outcomes from a single healthcare payer's perspective.
- Key outcomes measured included lifetime risk of pressure ulcers (stage 2-4), quality-adjusted life-years (QALYs), and lifetime costs.
- Four strategies were evaluated: pressure redistribution mattresses, oral nutritional supplements, skin emollients, and foam cleansing for incontinence care.
Main Results:
- Strategies averaged $11.66 per resident weekly, reducing lifetime risk with varying numbers needed to treat (NNT).
- Pressure redistribution mattresses (Strategy 1) and foam cleansing (Strategy 4) showed the best cost-effectiveness, with high probabilities of being cost-effective at a willingness to pay of $50,000 per QALY.
- Oral nutritional supplements (Strategy 2) and skin emollients (Strategy 3) demonstrated lower cost-effectiveness ratios.
Conclusions:
- Pressure redistribution mattresses for all residents are clinically and economically supported for long-term care settings.
- Perineal foam cleansers and dry skin emollients show potential cost-effectiveness for prevention, though further clinical evidence is needed.
- Targeted, evidence-based interventions can improve pressure ulcer prevention and reduce healthcare costs.
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