title: Do burn patients cost more? The intensive care unit costs of burn patients compared with controls matched for length of stay and acuity.
abstract: Modern intensive care management of burn patients is resource intensive with important ramifications for funding of regional burn services. The aim of this retrospective cohort study was to determine the intensive care unit costs for burn patients compared with nonburn patients matched for length of stay and severity of illness. The patient record was reviewed to compare costs associated with expendables (medications and fluids), investigations (laboratory and radiological tests), and physiotherapy sessions in 13 burn patients and 13 nonburn controls. Medical and nursing staff costs could not be differentially determined between groups. The cost of wound dressings were estimated for burn patients. The mean daily cost of burn patients was Australian dollars (AUD) 700.74 and AUD 697.99 for nonburn controls (P = .97), with an additional AUD 1411 estimated for nursing and medical staffing. There was no significant difference in the cost of expendables or laboratory tests between the groups. The largest drug and laboratory costs in both cases and controls were attributed to the use of meropenem and intravenous antifungals (25% and 30%, respectively) and arterial blood gas analysis (31% and 27%, respectively). Analgesics, anxiolytics, and sedatives costed AUD 21.58 more per day in burn patients than in controls (P = .054). Physiotherapy costs were AUD 18.62 higher per day in burn patients (P = .028), whereas radiology costs were AUD 108.10 higher in the control group (P = .001). Burn dressings costed AUD 120.77 per day. The authors found no significant difference in the mean daily intensive care unit cost of burn patients compared with controls matched for length of stay and acuity. However, physiotherapy and dressing costs were higher in burn patients, and there was a trend to increase costs associated with analgesic/anxiolytic/sedative medications. Antimicrobials accounted for a significant proportion of pharmacy costs in both groups.
authors.affiliation: Department of Intensive Care, Launceston General Hospital, Launceston, Tasmania.
authors.forename: Vikram
authors.initials: V
authors.lastname: Patil
authors.forename: Joel M
authors.initials: JM
authors.lastname: Dulhunty
authors.forename: Andrew
authors.initials: A
authors.lastname: Udy
authors.forename: Peter
authors.initials: P
authors.lastname: Thomas
authors.forename: Geraldine
authors.initials: G
authors.lastname: Kucharski
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lipman
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000191:economics; D001315:Australia; D001458:Bandages / Q000191:economics; D002056:Burns / Q000191:economics* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D006993:Hypnotics and Sedatives / Q000191:economics; D007362:Intensive Care Units / Q000191:economics*; D007902:Length of Stay / Q000191:economics*; D008297:Male; D026741:Physical Therapy Modalities / Q000191:economics; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000890:Anti-Infective Agents; D006993:Hypnotics and Sedatives