A cost model case comparison of current versus modern management of burns at a regional hospital in South Africa

Allorto, Nikki; Clarke, Damian; Thomson, S R

doi:10.1016/j.burns.2011.04.004

Cited by 22 publications

(19 citation statements)

References 16 publications

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“…The mean total healthcare cost per burn patient (85 studies) was $76,497 (range of $102–$717,306; median of $36,696) . The range includes costs in different market economies and healthcare settings, and the majority of studies calculated acute burn hospitalization costs only.…”

Section: Resultsmentioning

confidence: 99%

Costs of burn care: A systematic review

Hop

Polinder

Vlies

et al. 2014

Wound Repair Regeneration

134

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Burn care is traditionally considered expensive care. However, detailed information about the costs of burn care is scarce despite the increased need for this information and the enhanced focus on healthcare cost control. In this study, economic literature on burn care was systematically reviewed to examine the problem of burn-related costs. Cost or economic evaluation studies on burn care that had been published in international peer-reviewed journals from 1950 to 2012 were identified. The methodology of these articles was critically appraised by two reviewers, and cost results were extracted. A total of 156 studies met the inclusion criteria. Nearly all of the studies were cost studies (n = 153) with a healthcare perspective (n = 139) from high-income countries (n = 127). Hospital charges were often used as a proxy for costs (n = 44). Three studies were cost-effectiveness analyses. The mean total healthcare cost per burn patient in high-income countries was $88,218 (range $704-$717,306; median $44,024). A wide variety of methodological approaches and cost prices was found. We recommend that cost studies and economic evaluations employ a standard approach to improve the quality and harmonization of economic evaluation studies, optimize comparability, and improve insight into burn care costs and efficiency.

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Section: Resultsmentioning

confidence: 99%

Costs of burn care: A systematic review

Hop

Polinder

Vlies

et al. 2014

Wound Repair Regeneration

134

View full text Add to dashboard Cite

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“…21 The methods of estimating the direct cost [22][23][24] the bottom-up approach (microcosting) and the top-down approach (macrocosting). The bottom-up approach identifies and assesses the cost of each individual factor that contributes to the total cost to the healthcare system.…”

Section: Methodsmentioning

confidence: 99%

The cost effectiveness of early management of acute appendicitis underlies the importance of curative surgical services to a primary healthcare programme

Kong

Aldous

Handley

et al. 2013

annals

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INTRODUCTION Appendicitis in the developing world is a cause of significant preventable morbidity. This prospective study from a regional hospital in South Africa constructs a robust cost model that demonstrates the cost effectiveness of an efficient curative surgical service in a primary healthcare-orientated system. METHODS A prospective audit of all patients with acute appendicitis admitted to Edendale Hospital was undertaken from September 2010 to September 2011. A microcosting approach was used to construct a cost model based on the estimated cost of operative and perioperative interventions together with the associated hospital stay. For cost analysis, patients were divided into the following cohorts: uncomplicated appendicitis, complicated appendicitis with localised intra-abdominal sepsis, complicated appendicitis with generalised intra-abdominal sepsis, with and without intensive care unit admission. RESULTS Two hundred patients were operated on for acute appendicitis. Of these, 36% (71/200) had uncomplicated appendicitis and 57% (114/200) had perforation. Pathologies other than appendicitis were present in 8% (15/200) and these patients were excluded. Of the perforated appendices, 45% (51/114) had intra-abdominal contamination that was localised while 55% (63/114) generalised sepsis. The mean cost for each patient was: 6,578 ZAR (£566) for uncomplicated appendicitis; 14,791 ZAR (£1,272) for perforation with localised intra-abdominal sepsis and 34,773 ZAR (£2,990) for perforation with generalised intra-abdominal sepsis without intensive care admission. With intensive care admission it was 77,816 ZAR (£6,692). The total cost of managing acute appendicitis was 4,272,871 ZAR (£367,467). Almost 90% of this total cost was owing to advanced disease with abdominal sepsis and therefore potentially preventable. CONCLUSIONS Early uncomplicated appendicitis treated appropriately carries little morbidity and is relatively inexpensive to treat. As the pathology progresses, the cost rises exponentially. An efficient curative surgical service must be regarded as a cost effective component of a primary healthcare orientated system.

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“…bed cost per day, medications received, costs of dressings for wound care, and costs of surgical intervention. [1,4,5,[7][8][9] Chart reviews were undertaken of 80 patients' clinical and financial records of admission with a burn injury at Red Cross War Memorial Children's Hospital, Cape Town, SA. A random selection of 37 dressing changes (in 31 children) and 19 surgical interventions was observed, during which all itemised costs were recorded.…”

Section: Methodsmentioning

confidence: 99%

“…Determining which patients would truly benefit from such a strategy is clearly within the scope of the burn surgeon's discretion (by considering the extent, depth and aetiology of the burn injury, as well as psychosocial factors), but cost benefits will not be realised if hospital administrators limit access to the more expensive dressing modality without considering the considerable cost savings that can be obtained by use of such a strategy. [1][2][3][4][5][6] The purpose of this study was to determine the major cost drivers of managing an acute paediatric burn injury at a specialist paediatric burn unit. The anticipated lifetime implications (physical, psychological and financial) of these injuries are beyond the scope of the study.…”

Section: Researchmentioning

confidence: 99%