title: The costs of burn care: an analysis with an emphasis on the use of parenteral antimicrobials.
abstract: Because infection is a common cause of morbidity and mortality in patients with burns and intensive antibiotic therapy is often required, the focus of this study was to describe the patterns of use and costs of parenteral antibiotics in a burn unit. The study also evaluated the overall economics of burn care in our population. Forty-one percent of the study group received parenteral antimicrobial agents; the specific agents, indications, and costs are described. The costs of parenteral antibiotics made up a negligible 1.2% of hospital costs and only 12.4% of pharmacy costs. This study revealed the continued hospital losses related to the reimbursement system used by diagnosis-related groups for patients with Medicare. If all patients studied (n = 61) were reimbursed under diagnosis-related groups the unit would have experienced an annual loss of approximately 1.2 million dollars. If specialized burn care facilities are to remain, it may be necessary to reevaluate the appropriateness of the diagnosis-related group reimbursement system for burn-related injury. This is especially important if all third-party reimbursement sources consider conversion to this system of compensation.
authors.affiliation: College of Pharmacy, Medical University of South Carolina, Charleston 29425-0810.
authors.forename: D P
authors.initials: DP
authors.lastname: Nicolau
authors.forename: R L
authors.initials: RL
authors.lastname: White
authors.forename: L V
authors.initials: LV
authors.lastname: Friedrich
authors.forename: M B
authors.initials: MB
authors.lastname: Kays
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics*; D002053:Burn Units / Q000191:economics*; D002056:Burns / Q000188:drug therapy / Q000191:economics*; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007349:Insurance, Health, Reimbursement / Q000191:economics; D008297:Male; D006278:Medicare; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents