Net costs of hospital-acquired and pre-admission PUs among older people hospitalised in Ontario

Objective: To determine the net cost of hospital-acquired and pre-admission pressure ulcers (PUs) in an acute-care setting in Ontario, Canada. Method: Cases of PUs were identified among hospitalised patients using Ontario Case Costing Initiative (OCCI) data from 2002-2006. Inpatient costs included direct and overhead costs. To determine the net cost of PUs, cases were matched controlling for age, gender, most responsible diagnosis and comorbidity. Mean net costs were estimated using Bayesian linear mixed models methods. Results were also reported by PU severity. Results: In our study, there were 1351 cases of hospital-acquired PUs and 2523 cases of pre-admission PUs over 5 years. Net cost of hospital-acquired PU ranged between CA$44 000 for a category II PU to CA$90 000 for a category IV PU. For pre-admission PU net cost was between CA$11 000 to CA$18 500 for category II and category IV PU, respectively. The net cost of treating hospital-acquired PU is higher than pre-admission PU. Costs increase with increasing PU severity. Conclusion: The total net adjusted hospitalisation cost of a hospital-acquired PU in Ontario was CA$44 000-90 000, compared with CA$11 000-18 500 for a pre-admission PU. Future studies should determine the attributable cost of PU using patient-level data to verify the accuracy of the study results.