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Incidence of pressure ulcers in intensive care units and direct costs of treatment: Evidence from Iran
Authors:Ehsan Zarei  Elmira Madarshahian  Adeleh Nikkhah  Soheila Khodakarim
Affiliation:1. Department of Health Services Management, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran;3. Department of Epidemiology and Biostatistics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract:

Background and objective

Pressure ulcer (PU) is one of the important and frequent complications of hospitalization, associated with high treatment costs. The present study was conducted to determine the incidence of PU and its direct treatment costs for patients in intensive care unit (ICU) in Iran.

Material and methods

In this retrospective study, medical records of 643 discharged patients from ICU of two selected hospitals were examined. The demographic and clinical data of all patients and data of resources and services usage for patients with PU were extracted through their records. Data analysis was done using logistic regression tests in SPSS 22 software. The cost of PU treatment was calculated for each grade of ulcer.

Results

The findings showed that 8.9% of patients developed PU during their stay in ICU. Muscular paralysis (OR?=?5.1), length of stay in ICU (OR?=?4.0), diabetes (OR?=?3.5) age (OR?=?2.9), smoking (OR?=?2.1) and trauma (OR?=?1.4) were the most important risk factors of PU. The average cost of PU treatment varied from USD 12 for grade I PU to USD 66?834 for grade IV PUs. The total treatment costs for all studied patients with PU was estimated at USD 519?991.

Conclusion

The cost of PU treatment is significant. Since the preventive measures are more cost-effective than therapeutic measures, therefore, effective preventive interventions are recommended.
Keywords:Pressure ulcer  Intensive care unit (ICU)  Treatment cost  Iran
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