by William Mann on August 11, 2013

The Facts:
Pressure against the skin from prolonged periods of non-movement can result in lesions on the skin of various degrees of severity (4 stages) termed pressure ulcers. These skin lesions are painful, can significantly increase the risk of serious infection, and could result in death. Pressure ulcers can occur in patients that are in wheelchairs or are confined to a bed, but can also occur during short-term hospital stays after surgery.

Prevention of pressure ulcer formation is a major concern in patient care. In Canada, the prevalence of pressure ulcers is estimated to be up to 30% in some long-term care settings, 25% in some acute care settings, and 15% in some community care settings. It is anticipated that the incidence of pressure ulcers will dramatically increase with the aging population, suggesting a sustained need for pressure ulcer prevention in the future. Legislation in the United States has proclaimed pressure ulcers as “Never Events” and removed the treatment of pressure ulcers from Medicaid and Medicare, leaving the hospitals responsible for the costs.

The total cost for 3 months of care of a person with a fairly serious (Stage III) pressure ulcer was estimated to be $27,500 and the total cost of pressure ulcers for the health care system in Canada is approximately $2.1 billion annually. The annual cost to healthcare institutions in the US is approximated at $12 billion.

The Bottom Line:
The potential to spare individuals from additional medical complications, to reduce health care and legal costs by managing the problem of pressure ulcers through prevention is substantial.

References:
Woodbury, M. G. & Houghton, P. E. (2004). Prevalence of pressure ulcers in Canadian healthcare settings. Ostomy Wound Manage 50
Toronto Health Economics and Technology Assessment Collaborative. (2008). The cost-effectiveness of prevention strategies for pressure ulcers in long-term care homes in Ontario: Projections of the Ontario Pressure Ulcer Model.
Teague and Mahoney (2011). Early Prevention of Pressure Ulcers Among Elderly Patients Admitted Through Emergency Departments: A Cost-effectiveness Analysis. Annals of Emergency Medicine 58.
Bergstrom N, B. M. (1994). Treatment of Pressure Ulcers. Clinical Practice Guideline Number 14. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service.
Berlowitz, D., Lukas, C. Preventing pressure ulcers in hospitals. Agency for Healthcare Research and Quality. http://www.ahrq.gov