Turning for Ulcer Reduction (TURN) Study: An Economic Analysis.
BACKGROUND
The Turning for Ulcer Reduction (TURN) study was a multisite, randomized controlled trial that aimed to determine the optimal frequency of turning nursing facility residents with mobility limitations who are at moderate and high risk for pressure ulcer (PrU) development. Here we present data from the economic analysis.


OBJECTIVE
This economic analysis aims to estimate the economic consequences for Ontario of switching from a repositioning schedule of 2-hour intervals to a schedule of 3-hour or 4-hour intervals.


METHODS
Costs considered in the analysis included those associated with nursing staff time spent repositioning residents and with incontinent care supplies, which included briefs, barrier cream, and washcloths.


RESULTS
The total economic benefit of switching to 3-hour or 4-hour repositioning is estimated to be $11.05 or $16.74 per day, respectively, for every resident at moderate or high risk of developing PrUs. For a typical facility with 123 residents, 41 (33%) of whom are at moderate or high risk of developing PrUs, the total economic benefit is estimated to be $453 daily for 3-hour or $686 daily for 4-hour repositioning. For Ontario as a whole, assuming that there are 77,933 residents at 634 LTC facilities, 25,927 (33%) of whom are at moderate or high risk of developing PrUs, the total economic benefits of switching to 3-hour or 4-hour repositioning are estimated to be $286,420 or $433,913 daily, respectively, equivalent to $104.5 million or $158.4 million per year.


CONCLUSIONS
We did not consider the savings the Ontario Ministry of Health and Long-Term Care might incur should less frequent repositioning reduce the incidence of work-related injury among nursing staff, so our findings are potentially conservative.


CONCLUSIONS
A switch to 3-hour or 4-hour repositioning appears likely to yield substantial economic benefits to Ontario without placing residents at greater risk of developing PrUs.
Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada.
Mike
M
Paulden
University of Texas Health Sciences Center at Houston, Houston, Texas, USA.
Nancy
N
Bergstrom
International Severity Information Systems, Inc. and the Institute for Clinical Outcomes, Salt Lake City, Utah, USA.
Susan D
SD
Horn
University of Texas Health Sciences Center at Houston, Houston, Texas, USA.
Mary
M
Rapp
International Severity Information Systems, Inc. and the Institute for Clinical Outcomes, Salt Lake City, Utah, USA.
Anita
A
Stern
International Severity Information Systems, Inc. and the Institute for Clinical Outcomes, Salt Lake City, Utah, USA.
Ryan
R
Barrett
International Severity Information Systems, Inc. and the Institute for Clinical Outcomes, Salt Lake City, Utah, USA.
Michael
M
Watkiss
International Severity Information Systems, Inc. and the Institute for Clinical Outcomes, Salt Lake City, Utah, USA.
Murray
M
Krahn
D000369:Aged, 80 and over; D017046:Cost Savings / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000191:economics*; D056888:Patient Positioning / Q000191:economics* / Q000379:methods; D003668:Pressure Ulcer / Q000191:economics* / Q000517:prevention & control; D012307:Risk Factors; D013997:Time Factors