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Cost-effectiveness of subepidermal moisture measurement to prevent hospital-acquired pressure ulcers
John Posnett1, Joe Moss2, Lewis Michaelwaite3
1BA, DPhil, Health Economist, York, UK.
Objective:
A pressure ulcer (PU) develops initially at the cellular level, progressing through damage to subepidermal cells and surrounding tissues before it becomes visible on the surface of the skin. Changes in subepidermal moisture (SEM) are a biomarker for the early stages of PU development. The objective of this study was to evaluate the cost-effectiveness of adding measurement of SEM to current standard of care (SoC), with the aim of reducing the incidence of hospital-acquired pressure ulcers (HAPUs).
Method:
A decision-tree model was developed. Outcomes were the incidence of HAPUs, quality-adjusted life-years (QALYs) and costs to the UK National Health Service (NHS) at 2022/23 prices. The effects of parameter uncertainty were tested in univariate and probabilistic sensitivity analysis.
Results:
In a typical NHS acute hospital with 480 beds, the addition of SEM assessment as an adjunct to SoC is expected to reduce the incidence of HAPUs by 32.9% and lead to a cost saving of £26.53 per admission. The probability that adjunctive SEM is cost-effective at a threshold of £30,000 per QALY is 69%.
Conclusion:
SEM assessments make it possible to implement early and anatomy-specific interventions which can improve the effectiveness of PU prevention and reduce healthcare costs.
