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Use of the burn intervention score to calculate the charges of the care of burns
Authors:Islam Abdelrahman  Ingrid Steinvall  Mats Fredrikson  Folke Sjoberg  Moustafa Elmasry
Institution:1. The Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt;2. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden;3. Department of Hand Surgery, Plastic Surgery and Burns, Department of Clinical and Experimental Medicine, 8 Linköping University, Linköping, Sweden;4. Department of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden
Abstract:

Background

To our knowledge this is the first published estimate of the charges of the care of burns in Sweden. The Linköping Burn Interventional Score has been used to calculate the charges for each burned patient since 1993. The treatment of burns is versatile, and depends on the depth and extension of the burn. This requires a flexible system to detect the actual differences in the care provided. We aimed to describe the model of burn care that we used to calculate the charges incurred during the acute phase until discharge, so it could be reproduced and applied in other burn centres, which would facilitate a future objective comparison of the expenses in burn care.

Methods

All patients admitted with burns during the period 2010–15 were included. We analysed clinical and economic data from the daily burn scores during the acute phase of the burn until discharge from the burn centre.

Results

Total median charge/patient was US$ 28 199 (10th–90th centiles 4668-197 781) for 696 patients admitted. Burns caused by hot objects and electricity resulted in the highest charges/TBSA%, while charges/day were similar for the different causes of injury. Flame burns resulted in the highest mean charges/admission, probably because they had the longest duration of stay. Mean charges/patient increased in a linear fashion among the different age groups.

Conclusion

Our intervention-based estimate of charges has proved to be a valid tool that is sensitive to the procedures that drive the costs of the care of burns such as large TBSA%, intensive care, and operations. The burn score system could be reproduced easily in other burn centres worldwide and facilitate the comparison regardless of the differences in the currency and the economic circumstances.
Keywords:Burns  Charges  Intervention score  Costs  Payments
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