title: The cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders: A cost-of-illness study.
abstract: BACKGROUND
  The economic impact of pressure ulcer prevention and treatment is high. The results of cost-of-illness studies can assist the planning, allocation, and priority setting of healthcare expenditures to improve the implementation of preventive measures. Data on the cost of current practice of pressure ulcer prevention or treatment in Flanders, a region of Belgium, is lacking.
  
  
  OBJECTIVE
  To examine the cost of pressure ulcer prevention and treatment in an adult population in hospitals and nursing homes from the healthcare payer perspective.
  
  
  METHODS
  A cost-of-illness study was performed using a bottom-up approach.
  
  
  METHODS
  Hospitals and nursing homes in Flanders, a region of Belgium.
  
  
  METHODS
  Data were collected in a series of prospective multicentre cross-sectional studies between 2008 and 2013. Data collection included data on risk assessment, pressure ulcer prevalence, preventive measures, unit cost of materials for prevention and treatment, nursing time measurements for activities related to pressure ulcer prevention and treatment, and nursing wages. The cost of pressure ulcer prevention and treatment in hospitals and nursing homes was calculated as annual cost for Flanders, per patient, and per patient per day.
  
  
  RESULTS
  The mean (SD) cost for pressure ulcer prevention was €7.88 (8.21) per hospitalised patient at risk per day and €2.15 (3.10) per nursing home resident at risk per day. The mean (SD) cost of pressure ulcer prevention for patients and residents identified as not at risk for pressure ulcer development was €1.44 (4.26) per day in hospitals and €0.50 (1.61) per day in nursing homes. The main cost driver was the cost of labour, responsible for 79-85% of the cost of prevention. The mean (SD) cost of local treatment per patient per day varied between €2.34 (1.14) and €77.36 (35.95) in hospitals, and between €2.42 (1.15) and €16.18 (4.93) in nursing homes.
  
  
  CONCLUSIONS
  Related to methodological differences between studies, the cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders was found to be low compared to other international studies. Recommendations specific to pressure ulcer prevention are needed as part of methodological guidelines to conduct cost-of-illness studies.
authors: University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: Liesbet.demarre@gmail.com.
authors: Liesbet
authors: L
authors: Demarré
authors: University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors: Sofie
authors: S
authors: Verhaeghe
authors: Health Economics, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, ICHER (Interuniversity Center for Health Economics Research), Ghent, Belgium; Brussels University, Belgium.
authors: Lieven
authors: L
authors: Annemans
authors: University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Ghent University Hospital, Ghent, Belgium.
authors: Ann
authors: A
authors: Van Hecke
authors: University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors: Maria
authors: M
authors: Grypdonck
authors: University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; Department of Bachelor in Nursing, Artevelde University College, Ghent, Belgium.
authors: Dimitri
authors: D
authors: Beeckman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000191:economics*; D003668:Pressure Ulcer / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D015995:Prevalence
keywords: Cost-of-illness; Health economics; Hospitals; Nursing homes; Pressure ulcers; Prevention; Treatment