Cost-drivers of medical expenses in burn care management

Shin-Yi Tsai; Chon-Fu Lio; Wei-Cheng Yao; Chang-Pan Liu; Shou-Chuan Shih; Tina Yu-Ting Wang; Kam-Hang Leong; Fang-Ju Sun; Chien-Feng Kuo

doi:10.1016/j.burns.2020.01.004

Cost-drivers of medical expenses in burn care management

Burns. 2020 Jun;46(4):817-824. doi: 10.1016/j.burns.2020.01.004. Epub 2020 Apr 12.

Authors

Shin-Yi Tsai¹, Chon-Fu Lio², Wei-Cheng Yao³, Chang-Pan Liu⁴, Shou-Chuan Shih⁵, Tina Yu-Ting Wang², Kam-Hang Leong², Fang-Ju Sun⁶, Chien-Feng Kuo⁷

Affiliations

¹ Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Graduate Institute of Long-Term Care, Mackay Medical College, New Taipei City, Taiwan; Graduate Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States. Electronic address: stsai22@jhu.edu.
² Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan.
³ Department of Anesthesiology and Pain Medicine, Min-Sheng General Hospital, Tao-Yuan, Taiwan.
⁴ Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
⁵ Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
⁶ Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan.
⁷ Division of Infectious Diseases, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan. Electronic address: kakutsai1230@gmail.com.

PMID: 32291114
DOI: 10.1016/j.burns.2020.01.004

Abstract

Background: Profound differences exist in the cost of burn care globally, thus we aim to investigate the affected factors and to delineate a strategy to improve the cost-effectiveness of burn management.

Methods: A retrospective analysis of 66 patients suffering from acute burns was conducted from 2013 to 2015. The average age was 26.7 years old and TBSA was 42.1% (±25.9%). We compared the relationship between cost and clinical characteristics.

Results: The estimated cost of acute burn care with the following formula (10,000 TWD) = -19.80 + (2.67 × percentage of TBSA) + (124.29 × status of inhalation injury) + (147.63 × status of bacteremia) + (130.32 × status of respiratory tract infection).

Conclusion: The majority of the cost were associated with the use of antibiotics and burns care. Consequently, it is crucial to prevent nosocomial infection in order to promote healthcare quality and reduce in-hospital costs.

Keywords: Burn injury; Cost; Medical services; Policy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Anti-Bacterial Agents / economics*
Anti-Bacterial Agents / therapeutic use
Bacteremia / drug therapy
Bacteremia / economics*
Bacteremia / prevention & control
Body Surface Area
Burns / economics*
Burns / pathology
Burns / therapy
Costs and Cost Analysis
Cross Infection / drug therapy
Cross Infection / economics*
Cross Infection / prevention & control
Disease Management
Female
Health Care Costs*
Humans
Length of Stay / economics
Male
Pneumonia, Ventilator-Associated / drug therapy
Pneumonia, Ventilator-Associated / economics*
Pneumonia, Ventilator-Associated / prevention & control
Respiratory Tract Infections / drug therapy
Respiratory Tract Infections / economics
Respiratory Tract Infections / prevention & control
Retrospective Studies
Smoke Inhalation Injury
Taiwan
Wound Infection / drug therapy
Wound Infection / economics*
Wound Infection / prevention & control
Young Adult

Substances

Anti-Bacterial Agents