title: Cost-effectiveness Analysis of Nutritional Support for the Prevention of Pressure Ulcers in High-Risk Hospitalized Patients.
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients.
  
  
  METHODS
  An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted.
  
  
  METHODS
  Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year.
  
  
  METHODS
  Standard care included PrU prevention strategies, such as redistribution surfaces, repositioning, and skin protection strategies, along with standard hospital diet. In addition to the standard care, the intervention group received nutritional support comprising patient education, nutrition goal setting, and the consumption of high-protein supplements.
  
  
  METHODS
  The analysis was from a healthcare payer perspective. Key outcomes of the model included the average costs and quality-adjusted life years. Model results were tested in univariate sensitivity analyses, and decision uncertainty was characterized using a probabilistic sensitivity analysis.
  
  
  RESULTS
  Compared with standard care, nutritional support was cost saving at AU $425 per patient and marginally more effective with an average 0.005 quality-adjusted life years gained. The probability of nutritional support being cost-effective was 87%.
  
  
  CONCLUSIONS
  Nutritional support to prevent PrUs in high-risk hospitalized patients is cost-effective with substantial cost savings predicted. Hospitals should implement the recommendations from the current PrU practice guidelines and offer nutritional support to high-risk patients.
authors.affiliation: Haitham W. Tuffaha, PhD, is a Research Fellow, Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia. Shelley Roberts, PhD, is a Research Fellow, School of Allied Health Sciences, Griffith University, Queensland, Australia. Wendy Chaboyer, PhD, is Professor and Director, National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Nursing Interventions for Hospitalised Patients Centre for Health Practice Innovation, Griffith University, Gold Coast, Australia. Louisa G. Gordon, PhD, is Principal Fellow, Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia. Paul A. Scuffham, PhD, is director, Population and Social Health Research Program, and Professor, Health Economics, Griffith University, Queensland, Australia.
authors.forename: Haitham W
authors.initials: HW
authors.lastname: Tuffaha
authors.forename: Shelley
authors.initials: S
authors.lastname: Roberts
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Gordon
authors.forename: Paul A
authors.initials: PA
authors.lastname: Scuffham
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D018529:Nutritional Support / Q000191:economics*; D017063:Outcome Assessment, Health Care; D003668:Pressure Ulcer / Q000191:economics* / Q000517:prevention & control* / Q000628:therapy; D011322:Primary Prevention / Q000191:economics; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors