FOURTEENTH ANNUAL EUROPEAN PRESSURE ULCER ...

Wednesday August 31st
Proceedings of the 14th Annual European Pressure Ulcer Meeting
Oporto, Portugal
Pressure ulcers: the economic impact
Verdú José 1*
1* Community Nursing, Preventive Medicine, Public Health and History of Science Department. University
of Alicante. Spain, pepe.verdu@ua.es
Introduction
Nowadays no one doubts that pressure ulcers are an
important problem for all healthcare systems. Pressure
ulcers are a serious and debilitating condition treated
in all care settings, which have a significant impact on
both patients and on health care resources. However,
there are still few studies in the published literature
aimed at measuring the economic impact of this
condition and some of these studies are based on very
general assumptions.
The cost is combined by direct high drug costs (as
cleansing materials, dressings, treatment of
complications, surgical and diagnostic interventions,
pain management, nursing time increases, increased
hospital stays and so on) and other indirect costs
(costs related to quality of life and help to perform
activities of daily living, including litigation expenses,
related Springs...).
Perhaps, the more accurate study of costs associated
with pressure ulcers, performed in Europe, was
undoubtedly discussed by Bennet, Dealey and Posnett
in the UK [1]. The authors, using an inductive
methodology, determined treatment costs. Finally,
estimated costs of treating a pressure ulcer could
range from 1080 pounds for stage I up to 15,000 for
stage IV, emphasizing that the cost increases with the
stage, because it increases the healing time and
incidence of complications. the estimated total cost for
the health care and social system was around 2000
million pounds per year (representing about 5.1% of
gross expenditure of the British Health Service in the
year 1999/2000).
In Spain, the Prevalence Study of Pressure Ulcers in
Rioja (1999) [2], with estimates clearly downward,
allowed a first global approach to the annual cost of
treatment across the country, reaching it over the
seventy billion of pesetas. More recently, in 2007,
GNEAUPP conducted a new study to estimate the
national costs [3]. This study shows that the cost to
heal a pressure ulcer increases substantially with the
severity of the ulcer, ranging from 24€ (grade I) to
6,802€ (grade IV) for patients treated in hospital. Costs
increase with ulcer severity because the time to heal is
longer and because the incidence of complications is
higher in more severe cases. The total cost of
pressure ulcer treatment in Spain is approximately 461
million € (around 5% of total annual health care
expenditure). Of this, 15% represents the cost of
38
dressings and other materials, 19% is the cost of
nurse time and 45% is the cost of ulcer-related
hospital stays.
Historically, pressure ulcers have not been regarded
as an important public health issue in Spain as well as
other countries. However by comparing their cost with
the costs associated with other indications considered
key targets for any developed healthcare system (such
as AIDS or type II diabetes), we can gain a better
understanding of the true dimensions of the problem.
In addition to the cost to the healthcare system, many
published papers have shown that pressure ulcers
present a significant associated morbidity and
mortality, diminishing the quality of life of those who
suffer from them.
Clinical relevance
This conference Highlight the high impact that
pressure ulcer have on national health costs.
Conflict of Interest
José Verdú is co-author of several papers related to
the title of this piece of work.
References
[1] Bennett G, Dealey C, Posnett J. The cost of
pressure ulcers in the UK. Age and Ageing. 2004;
33:230-235
[2] Soldevilla JJ, Torra JE. Epidemiología de las
úlceras por presión en España. Estudio piloto en la
Comunidad Autónoma de la Rioja. Gerokomos. 1999;
10(2):75-87
[3] Soldevilla JJ, Torra JE, Posnett J, Verdú J, San
Miguel L. The Burden of Pressure Ulcers in Spain.
Wounds. 2007; 19(7):201-206
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