Socio-economic cost and health-related quality of life of burn victims in Spain

doi:10.1016/j.burns.2007.12.011

Burns

Volume 34, Issue 7, November 2008, Pages 975-981

https://doi.org/10.1016/j.burns.2007.12.011 Get rights and content

Abstract

Objectives

The aim of the study was to determine the economic burden (direct and indirect costs) of burn victims and the impact of burn on health-related quality of life in Spain.

Methods

In 2003, a cross-sectional study was carried out with 898 burned people. Data regarding demographic features, health resource use, informal care, indirect costs and quality of life were prospectively collected through hospital admission databases and questionnaires filled out by burn victims and caregivers.

Results

The mean annual cost (direct and indirect) per burn patient was US$ 99,773. The most important categories of costs were those of in-patient care and temporary and permanent disability. Direct healthcare costs of burn patients represented 19.6% of the total. Total annual cost for burn patients in Spain was US$ 313 million. The mean health-related quality of life measured by European Quality of Life 5-Dimension score was 0.84 and the mean visual analogue score was 67.

Conclusions

The costs of burn are higher than those of many other conditions, and a cost-effectiveness assessment of the different interventions for burn should become a priority in health policy.

Introduction

Cost-of-illness studies inform about patterns and uses of resources for a particular condition, enabling a greater understanding of the framework in which decisions about resource allocation can be made. However, cost-of-illness studies, unlike cost-effectiveness and cost-utility studies, are not able directly to inform decisions about the effective allocation of resources to fund particular treatments or strategies.

The high frequency of severe burn, and the consequences it has on society in terms of mortality, morbidity and economic and social costs, justify the particular attention paid to burn victims by health authorities and society in general. The derived impact of this trauma on social, family and work environments is constantly increasing in importance and in direct and indirect cost. Burn care is known to be among the most costly areas of healthcare as a result of high staff-to-patient ratios, long hospital stays and expensive equipment [1]. However, there are few studies analysing the cost-of-illness for burns, including indirect and informal care costs [2], [3]. In addition, we could not find in the published literature any studies of the quality of life of burned people. The aim of this study was to determine the economic burden (direct and indirect costs), as well as the health-related quality of life (HRQL), for people with burns in Spain in 2003.

Section snippets

Research design and population

A prospective cross-sectional study was carried out with 898 people diagnosed with different diagnosis-related degrees (DRGs) of burn. Participants signed a letter of informed consent. These data were used to extrapolate costs.

Data and variables

Burn data were collected over 12 months and classified according to the DRG system (DRG 456: burns, transferred to another acute care facility; DRG 457: extensive burns without operative procedure; DRG 458: non-extensive burns with skin graft; DRG 459: non-extensive burns

Results

The participants’ mean age was 36.4 years (females 40.4 years); 65% were men. The majority were from an urban environment, without any previous accident at work. They were classified according to DRG; most commonly burns were caused by scalding or fire (70%) and 70% were second-degree burns (Table 1).

Table 2 shows direct (healthcare and non-healthcare) and indirect costs per participant. The most important categories of costs in the different DRGs were for hospital admissions and temporary and

Discussion

Among health-related problems during the last few decades, burn appears to have some of the most important social consequences, not only in Spain but also in other industrialised countries. People with severe burns require hospital admission for infection of the wound, loss of electrolytes, fluids and metabolites, breathing difficulties and functional alterations, as well as important symptoms such as pain [18]. When we compare the mean annual cost of burn victims, i.e. US$ 99,773, with the

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Socio-economic cost and health-related quality of life of burn victims in Spain

Abstract

Objectives

Methods

Results

Conclusions

Introduction

Section snippets

Research design and population

Data and variables

Results

Discussion

Burns

Burns

Health Policy

Value Health

Burns

Burns

Burns

Am J Infect Control

Burns

Burns

Costs and outcomes of medical intensive care?

Med Care

Cost-effectiveness analysis applied to the treatment of chronic renal disease

Med Care

Cost-of-illness methodology: a guide to assessment practices and procedures

Milbank Q

The lifetime cost of injury

Inquiry

Philosophical origins of the economic valuation of life

Milbank Q

Indirect cost in economic evaluation: the opportunity cost of unpaid inputs

Health Econ

Evaluation of life and limb: a theoretical approach

J Polit Econ