title: Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged.
abstract: BACKGROUND
  Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far.
  
  
  OBJECTIVE
  The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years).
  
  
  METHODS
  A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used.
  
  
  RESULTS
  Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed.
  
  
  CONCLUSIONS
  Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was identified. Because of the overall low methodological quality clear cut conclusions cannot be drawn. Robust and large scales economic evaluations about skin conditions and disease in aged populations are needed in the future.
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: andrea.lichterfeld@charite.de.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lichterfeld-Kottner
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hahnel
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Blume-Peytavi
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Kottner
mesh_terms: D000367:Age Factors; D000368:Aged; D001513:Beds; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017453:Dermatitis, Irritant / Q000191:economics / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D065228:Non-Randomized Controlled Trials as Topic; D064887:Observational Studies as Topic; D003668:Pressure Ulcer / Q000191:economics / Q000517:prevention & control / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012867:Skin / Q000293:injuries*; D017592:Skin Care / Q000191:economics* / Q000295:instrumentation / Q000379:methods
keywords: Aged; Economic analyses; Incontinence associated dermatitis; Pressure ulcers; Skin tears