El impacto económico de las lesiones por presión. Revisión bibliográfica integrativa

  1. Joan-Enric Torra-Bou
  2. Francisco-P. García-Fernández
  3. Gemma Pérez-Acevedo
  4. Raquel Sarabia-Lavin
  5. Paula Paras-Bravo
  6. J. Javier Soldevilla-Ágreda
  7. Manuel Rodríguez-Palma
  8. José Verdú-Soriano
Revista:
Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

ISSN: 1134-928X

Año de publicación: 2017

Volumen: 28

Número: 2

Páginas: 83-97

Tipo: Artículo

Otras publicaciones en: Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

Resumen

Resumen: Las lesiones por presión son un importante problema de salud con una gran repercusión epidemiológica y un gran impacto a nivel de salud y calidad de vida que genera importantes costes para las personas, instituciones y sistemas de salud. A pesar de la importancia económica del problema de las lesiones por presión, prácticamente no existe información sistematizada acerca de las diferentes dimensiones de su coste. Para cubrir esta falta de información se planteó la realización de una revisión integrativa acerca de la dimensión económica del problema de las lesiones por presión. Se han identificado y analizado 89 documentos con información económica acerca del problema de las lesiones por presión. La información se ha sistematizado basándose en los siguientes apartados: tiempo necesario para la cicatrización, impacto en las estancias hospitalarias, costes relacionados con la seguridad de los pacientes, impacto en los grupos relacionados de diagnóstico, coste total, coste por episodio, por tipo de tratamiento, de las complicaciones, de las demandas legales, de los años de vida ganados ajustados a calidad de vida, en pacientes lesionados medulares y con otras condiciones, y los costes de medidas preventivas.

Referencias bibliográficas

  • Torra-Bou, JE, Verdú-Soriano, J, Sarabia-Lavin, R, Paras-Bravo, P, Soldevilla-Ágreda, JJ, García-Fernández, FP. (2016). Las úlceras por presión como problema de seguridad del paciente. Gerokomos. 27. 161
  • Torra, JE, Rueda, J, Soldevilla, JJ, Martínez Cuervo, F, Verdú Soriano, J. (2003). 1er Estudio Nacional de Prevalencia de Úlceras por Presión en España Epidemiología y variables definitorias de las lesiones y pacientes. Gerokomos. 14. 37-47
  • Soldevilla Agreda, JJ, Torra i Bou, JE, Verdú Soriano, J, Martínez Cuervo, F, López Casanova, P, Rueda López, J. (2006). 2º Estudio Nacional de Prevalencia de Úlceras por Presión en España Epidemiología y variables definitorias de las lesiones y pacientes. Gerokomos. 17. 145
  • Soldevilla Agreda, JJ, Torra I Bou, JE, Verdú Soriano, J, López Casanova, P. (2011). 3er Estudio Nacional de Prevalencia de Úlceras por Presión en España, 2009. Epidemiología y variables definitorias de las lesiones y pacientes. Gerokomos. 22. 77-90
  • Pancorbo Hidalgo, PL, García Fernández, FP, Torra i Bou, JE, Verdú Soriano, J, Soldevilla Agreda, JJ. (2014). Epidemiología de las úlceras por presión en España en 2013, 4.º Estudio Nacional de Prevalencia. Gerokomos. 25. 162
  • Torra-Bou, JE, Rueda-López, J. (2016). Atención integral a las heridas crónicas. 2. GNEAUPP-FSSJ. Logroño.
  • Hurd, T. (2013). Evaluating the costs and benefits of innovations in chronic wound care products and practices. Ostomy Wound Manag. 1-15
  • Alfonso, JL, Blasco Pérez, S, Moreno Canovas, J, Martinez, MM, Martinez, IM, Martin Moreno, JM. (2007). Are we really seeing the total costs of surgical site infections? A Spanish study. Wound Repair Reg. 15. 474
  • Hibbs, P. (1988). The economics of pressure ulcer prevention. Decubitus. 1. 32
  • Soldevilla Agreda, JJ, Torra I Bou, JE, Posnett, J, Verdú Soriano, J, San Miguel, L, Mayan Santos, JL. (2007). Una aproximación al impacto del coste económico del tratamiento de las úlceras por presión en España. Gerokomos. 18. 201
  • Dealey, C, Posnnett, J, Walker, A. (2012). The cost of pressure ulcers in the United Kingdom. J Wound Care. 21. 261
  • Lapsley, HM, Vogels, R. (1996). Cost and prevention of pressure ulcers in an acute teaching hospital. Int J Qual Health Care. 8. 61
  • Zhan, Ch, Miller, MR. (2003). Excess length of stay, charges, and mortality atributable to medical injuries during hospitalization. JAMA. 290. 1868
  • Graves, N, Birrell, FA, Withby, M. (2005). Modeling the economic loses from pressure ulcers among hospitalized patients in Australia. Wound Repair Regen. 23. 462
  • Anthony, D, Reynolds, T, Russell, L. (2004). The role of hospital acquired pressure ulcer in length of stay. Clin Eff Nurs. 8. 4-10
  • Graves, N, Birell, F, Whitney, M. (2005). The effect of pressure ulcers on length of hospital stay. Infect Control Hosp Epidemiol. 26. 293
  • Donner, B, Posthauer, ME, Thomas, D. (2009). The role of nutrition in pressure ulcer prevention and treatment: The National Pressure Ulcer Advisory Panel White Paper.
  • Russo, CA, Steiner, C, Spector, W. (2006). Hospitalizations related to presure ulcers among adults 18 years and older, 2006. Agency for Healthcare Research and Quality (US). Rockville (MD).
  • Lyder, CH, Wang, Y, Metersky, M, Curry, M, Kliman, R, Verzier, NR. (2012). Hospital acquired pressure ulcers. Results from the National Medicare Patient Safety Monitoring System Study. J Am Geriatr Soc. 60. 1603
  • Lyder, CH, Ayello, EA. (2009). Annual checkup: The CMS Pressure ulcer present-on-admission indicator. Adv Skin Wound Care. 22. 476
  • Banks, MD, Graves, N, Bauer, J, Ash, S. (2010). The costs arising from pressure ulcers attributable to malnutrition. Clin Nutr. 29. 180
  • (2014). Do healthcare systems promote the prevention of pressure ulcers?. Deloitte Consulting. Belgium.
  • Vetrano, DL, Landi, F, De Buyser, SL, Carfì, A, Zuccalà, G, Petrovic, M. (2014). Predictors of length of hospital stay among older adults admitted to acute care wards: a multicentric observational study. Eur J Int Med. 25. 56-62
  • Castelli, A, Daidone, S, Jacobs, R, Kasteridis, P, Street, AD. (2015). The determinants of costs and length of stay for hip fracture patients. PloS ONE. 10. 0133545
  • Nguyen, KH, Chaboyer, W, Whitty, JA. (2015). Pressure injury in Australian public hospitals: a cost-of-illness study. Austr Health Rev. 39. 329
  • Encinosa, WE, Hellinger, FJ. (2005). The Impact of Medical Errors on Ninety-Day Costs and Outcomes: An Examination of Surgical Patients. Health Services Research. 2067
  • Milstein, A. (2009). Ending extra payment for "Never events". Stronger incentives for patient's safety. N Engl J Med. 360. 2388
  • Mallow, PJ, Pandya, B, Horblyuk, R, Kaplan, HS. (2013). Prevalence and cost of hospital medical errors in the general elderly United States population. J Med Econ. 12. 1367
  • Spector, W, Limcangco, R, Owen, PL, Steiner, CA. (2016). Marginal hospital cost of surgery-related hospital acquired pressure ulcers. Med Care. 54. 845
  • Swaford, K, Culpepper, R, Dunn, C. (2016). Use of a comprehensive program to reduce the incidence of hospital acquired pressure ulcers in an intensive care unit. AJCC. 25. 152
  • (2009). Grupos de diagnósticos relacionados (GRD). Temas de Coyuntura. 23. 1-5
  • Stausberg, J, Kröger, K, Maier, I, Schneider, H, Niebel, W. (2005). Pressure ulcers in secondary care: Incidence, prevalence, and relevance. Adv Skin Wound Care. 18. 140
  • Red Española de Costes Hospitalarios.
  • Allué, N, Chiarello, P, Bernal-Delgado, E, Castells, X, Giraldo, P, Martínez, N. (2014). Impacto económico de los efectos adversos en los hospitales españoles a partir del conjunto Mínimo Básico de Datos. Gac Sanit. 28. 48-54
  • Touche, R. (1993). The cost of pressure sores. Report to the Department of Health. Department of Health. London.
  • Manley, MT. (1978). Incidence, contributing factors and costs of pressure sores. S Afric Med J. 53. 217
  • Hibbs, P. (1982). Pressure sores: a system of prevention. Nurs Mirr. 155. 25
  • Scales, JT, Poole, AG, Ludman, WR. (1982). "Vaperm" patient support-system: A new general purpose hospital mattress. Lancet. 1150
  • (1995). Pressure sores a key quality indicator. A guide for NHS purchasers and providers. BAPS Health Publications Unit. Lancshire.
  • Schoonhoven, L, Bousema, MT, Buskens, E. (2007). The prevalence and incidence of pressure ulcers in hospitalized patients in the Netherlands: A prospective inception cohort study. Int J Nurs Stud. 44. 927
  • Bennett, G, Dealey, C, Posnett, J. (2004). The cost of pressure ulcers in the UK. Age Aeging. 33. 230
  • Severens, JL, Habraken, JM, Duivenvoorden, S, Frederiks, CM. (2002). The cost of illness of pressure ulcers in the Netherlands. Adv Skin Wound Care. 15. 72
  • Graves, N, Birrell, FA, Withby, M. (2005). Modeling the economic loses from pressure ulcers among hospitalized patients in Australia. Wound Repair Regen. 23. 462
  • Gethin, G, Jordan-O'Brien, J, Moore, Z. (2005). Estimating costs of pressure area management based on a survey of ulcer care in one Irish hospital. J Wound Care. 14. 162
  • VanGilder, C, Amiung, S, Harrison, P, Meyer, S. (2009). Results of the 1008-2009 International Pressure Ulcer Prevalence Survey and a 3-year, acute care, unit-specific analysis. Ostomy Wound Manage. 55. 39-45
  • Landro, L. (2007). The informed patient: Hospitals combat dangerous bedsore. Wall St J.
  • Redy, M, Gill, SS, Rochon, PA. (2006). Preventing pressure ulcers: A systematic review. JAMA. 296. 974
  • Bales, I, Podwojski, A. (2009). Reaching for the moon: achieving zero pressure ulcer prevalence. J Wound Care. 18. 137
  • Galvin, PA, Curley, MAQ. (2012). The Braden Q+P: A pediatric perioperative pressure ulcer risk assessment and intervention tool. AORN J. 96. 261
  • Soldevilla, J, Torra i Bou, JE, Verdú, J, Rueda, J, Roche, E. (2006). Epidemiology of Chronic Wounds in Spain: Results of the First National Studies on Pressure and Leg Ulcer Prevalence. Wounds. 18. 213
  • Posnett, J, Soldevilla Agreda, JJ, Torra i Bou, JE. (2007). Epidemiología, coste y repercusiones legales de las úlceras por presión en España, años 2005-2006. Smith&Nephew. Sant Joan Despí.
  • Sanada, H, Nakgami, G, Mizokami, Y, Minami, Y, Yamamoto, A, Oe, M. (2010). Evaluating the effect of the new incentive system for high-risk pressure ulcer patients on wound healing and cost-effectiveness: A cohort study. Int J Nusr Stud. 47. 279
  • Trueman, P, Whitehead, AJ. (2010). The economics of pressure relieving surfaces: an illustrative case study of the impact of high-specification surfaces on hospital finances. Int Wound J. 7. 48-54
  • (2011). Preventing Pressure Ulcers in Hospitals. Are We Ready for This Change?: A Toolkit for Improving Quality of Care. Agency for Healthcare Research and Quality. Rockville, MD.
  • Silva, AJ, Martins Pereira, S, Rodrigues, A, Rocha, AP, Varela, J, Gomes, LM. (2013). Custo económico do tratamiento das úlceras por pressao: uma abordagem teórica. Rev Esc Enferm USP. 47. 971
  • Santamaria, N, Santamaria, H. (2014). An estimate of the potential Budget impact of using prophylactic dressings to prevent hospital-acquired Pus in Australia. J Wound Care. 23. 583
  • Demarré, L, Van Lancker, A, Van Hecke, A, Verhaeghe, S, Grypdonck, M, Lemey, J. (2015). The cost of prevention and treatment of pressure ulcers: A systematic review. Int J Nurs Stud. 52. 1754
  • (1990). The economics of pressure ulcer prevention. Decubitus. 1. 32
  • Allman, RM, Laprade, CA, Noel, LB, Walker, JM, Moorer, CA, Dear, MR. (1986). Pressure sores among hospitalized patients. Ann Intern Med. 105. 337
  • Hibbs, PJ. (1987). Pressure area care for the city & Hackney Health Authority.
  • Brandeis, GH, Morris, JN, Nash, DJ, Lipsitz, LA. (1990). The Epidemiology and natural history of pressure ulcers in elderly nursing home residents. JAMA. 264. 2905
  • Lapsley, HM, Vogels, R. (1996). Cost and prevention of pressure ulcers in an acute teaching hospital. Intern J Qual Health Care. 8. 61
  • Frantz, RA, Bergquist, S, Specht, J. (1995). The cost of treating pressure ulcers following implementation of a research-based skin care protocol in a long-term care facility. Adv Wound Care. 8. 36-44
  • Illman, J. (1994). Patients under pressure. A flesh-roting condition is killing 2000 people every year in Britain. The Guardian. 14
  • Allen, J, Houghton, PE. (2004). A case study for electrical stimulation on a stage III pressure ulcer. Wound Care Canada. 2. 34
  • Schuurman, JP, Schoonhoven, L, Defloor, T, van Engelshoven, I, van Ramshorst, B, Buskens, E. (2009). Economic evaluation of pressure ulcer care a cost: minimization analysis of preventive strategies. Nurs Econ. 27. 390-415
  • Courtney, BA, Ruppman, JB, Cooper, HM. (2006). Save our skin: Initiative cuts pressure ulcer incidence in half. Nurs Manag. 36-42
  • (1988). The prevention and management of pressure sores within health authorities. Advisory document. Kings Fund. London.
  • Posnett, J, Gottrup, F, Lundgren, H, Saal, G. (2009). The resource impact of wounds on health care providers in Europe. J Wound Care. 18. 154
  • Brem, H, Maggi, J, Nierman, D, Rolnitzky, L, Bell, D, Rennert, R. (2010). High cost of stage IV pressure ulcers. Am J Surg. 200. 473
  • (2011). Preventing Pressure Ulcers in Hospitals. Are We Ready for This Change? A Toolkit for Improving Quality of Care. Agency for Healthcare Research and Quality. Rockville, MD.
  • (2012). Pressure ulcers in Sweede. Research overview and calculation of inpatient care costs.
  • Schesel, ES, Ger, R, Oddsen, R. (2012). The costs and outcomes of treating a deep pressure ulcer in a patient with quadriplegia. Ostomy Wound Manag. 58. 41
  • Chan, BC, Nanwa, N, Mittmann, N, Byrant, D, Coyte, PC, Houghton, PE. (2013). The average cost of pressure ulcer management in a community dewling spinal cord injury population. Int Wound J. 10. 431
  • Ackroyd-Stolarz, S. (2014). Improving the prevention of pressure ulcers as a way to reduce health care expenditures. CMAJ. 186. 370
  • Spetz, J, Brown, DS. (2013). The value of reducing hospital-acquired pressure ulcer prevalence. An illustrative analysis. JONA. 43. 235
  • (2014). Partnership for Patients. Agency for Healthcare Research and Quality USA.
  • Dale, M, Cox-Martin, B, Shaw, P, Carolan-Rees, G. (2014). Cost-effective non-surgical treatment of chronic pressure ulcers in the community. Comm Wound Care. 8-12
  • Costa Lima, AF, Castilho, V, Caetano Baptista, CM, Brunet Rogenski, NM, Rogenski, KE. (2016). Direct cost of dressings for pressure ulcers in hospitalized patients. Rev Bras Enferm. 69. 269
  • Morehead, D, Blain, B. (2014). Driving hospital-acquired pressure ulcers to zero. Crit Care Nurs Clin N Am. 26. 559
  • (2011). Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care. Agency for Healthcare Research and Quality. Rockville, MD.
  • Costa, MA, Matozinhos, AC, Trigueiro, PS, Cunha, RC, Moreira, LR. (2015). Custos de tratamento de úlceras por pressao em unidades de cuidados prolongados em uma instituçao hospitalar de Minas Gerais. Enferm Rev. 18. 58-74
  • Lyder, CH. (2011). Preventing heel pressure ulcers: Economic and legal implications. Nurs Manag. 16
  • Chopra, T, Marchaim, D, Awali, AD. (2016). Risk factors and acute in hospital costs for infected pressure ulcers among gunshot-spinal cord injury victims in southestern Michigan. Am J Infect Control. 44. 315
  • White, R. (2014). The true cost of pressure ulcers. Br J Healthcare Manage. 20. 554
  • (2016). Leaf Healthcare White Paper. The financial impact of pressure ulcers. A review of the direct and indirect costs associated with pressure ulcers. Leaf Healthcare. Pleasanton, CA.
  • Alvis, N, Valenzuela, MT. (2010). Los QUALYs y DALYs como indicadores sintéticos de salud. Rev Med Chile. 138. 83
  • Soares, MO, Dumville, JC, Ashby, RL. (2013). Methods to assess cost-effectiveness and value of further research when data are sparse: Negative-Pressure Wound Therapy for severe pressure ulcers. Med Decis Making. 33. 415
  • Marsden, G, Jones, K, Neison, J, Avital, L, Collier, M, Stansby, G. (2015). A cost-effectiveness analysis of two different repositioning strategies for the prevention of pressure ulcers. J Adv Nurs. 71. 2878
  • Filius, A, Damen, THC, Schuijer-Masskant, KP, Polinder, S, Hovius, SE, Walbeehm, ET. (2013). Cost analysis of surgically treated pressure sores stages III and IV. J Plast Rec Aesth Surg. 66. 1580
  • DeVivo, MJ, Farris, VF. (2011). Causes and costs of unplaned hospitalizations among persons with spinal cord injury. Top Spinal Cord Inj Rehabil. 16. 53-61
  • Stroupe, KT, Manheim, L, Evans, Ch T. (2011). Cost of treating pressure ulcers for veterans with spinal cord injury. Top Spinal Cord Inj Rehabil. 16. 62-73
  • Pancorbo-Hidalgo, PL, García-Fernández, FP. (2002). Estimación del coste económico en la prevención de úlceras por presión en una unidad hospitalaria. Gerokomos. 13. 164
  • Verdú-Soriano, J, López-Casanova, P, Fuentes-Pages, G, Torra i Bou, JE. (2004). Prevención de UPP en talones. Impacto clínico y económico en una unidad de medicina interna. Rev Rol Enf. 27. 86-90
  • Moore, Z, Cowman, S, Posnett, J. (2013). An economic analysis of repositioning for the prevention of pressure ulcers. J Clin Nurs. 22. 2354
  • Swaford, K, Culpepper, R, Dunn, CH. (2016). Use of a comprehensive program to reduce the incidence of hospital-acquired pressure ulcers in an intensive care unit. Am J Crit Care. 25. 152
  • Demarré, L, Verhaeghe, S, Annemans, L, Van Hecke, A, Grypdonck, M, Beeckman, D. (2015). The cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flandes: A cost-of-illness study. Int J Nurs Stud. 1166
  • Palfreyman, SJ, Stone, PW. (2015). A systematic review of economic evaluations assessing interventions aimed at preventing or treating pressure ulcers. Int J Nurs Stud. 52. 769
  • Whittemore, R, Knafl, K. (2005). The integrative review updated methodology. J Adv Nurs. 52. 546