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Cost-effectiveness of a pressure ulcer quality collaborative
BACKGROUND: A quality improvement collaborative (QIC) in the Dutch long-term care sector (nursing homes, assisted living facilities, home care) used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs). The collaborative consisted of a core team of expert...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895580/ https://www.ncbi.nlm.nih.gov/pubmed/20515473 http://dx.doi.org/10.1186/1478-7547-8-11 |
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author | Makai, Peter Koopmanschap, Marc Bal, Roland Nieboer, Anna P |
author_facet | Makai, Peter Koopmanschap, Marc Bal, Roland Nieboer, Anna P |
author_sort | Makai, Peter |
collection | PubMed |
description | BACKGROUND: A quality improvement collaborative (QIC) in the Dutch long-term care sector (nursing homes, assisted living facilities, home care) used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs). The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. METHODS: We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials). Quality of life (Qol) weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1) not sustained, (2) partially sustained, and (3) completely sustained. RESULTS: Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol) of patients increased by 0.02 Quality Adjusted Life Years (QALY)s in two years; healthcare costs increased by €2000 per patient; the Incremental Cost-effectiveness Ratio (ICER) was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. CONCLUSIONS: During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained. |
format | Text |
id | pubmed-2895580 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-28955802010-07-02 Cost-effectiveness of a pressure ulcer quality collaborative Makai, Peter Koopmanschap, Marc Bal, Roland Nieboer, Anna P Cost Eff Resour Alloc Research BACKGROUND: A quality improvement collaborative (QIC) in the Dutch long-term care sector (nursing homes, assisted living facilities, home care) used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs). The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. METHODS: We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials). Quality of life (Qol) weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1) not sustained, (2) partially sustained, and (3) completely sustained. RESULTS: Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol) of patients increased by 0.02 Quality Adjusted Life Years (QALY)s in two years; healthcare costs increased by €2000 per patient; the Incremental Cost-effectiveness Ratio (ICER) was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. CONCLUSIONS: During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained. BioMed Central 2010-06-01 /pmc/articles/PMC2895580/ /pubmed/20515473 http://dx.doi.org/10.1186/1478-7547-8-11 Text en Copyright ©2010 Makai et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Makai, Peter Koopmanschap, Marc Bal, Roland Nieboer, Anna P Cost-effectiveness of a pressure ulcer quality collaborative |
title | Cost-effectiveness of a pressure ulcer quality collaborative |
title_full | Cost-effectiveness of a pressure ulcer quality collaborative |
title_fullStr | Cost-effectiveness of a pressure ulcer quality collaborative |
title_full_unstemmed | Cost-effectiveness of a pressure ulcer quality collaborative |
title_short | Cost-effectiveness of a pressure ulcer quality collaborative |
title_sort | cost-effectiveness of a pressure ulcer quality collaborative |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895580/ https://www.ncbi.nlm.nih.gov/pubmed/20515473 http://dx.doi.org/10.1186/1478-7547-8-11 |
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