1
|
Pokorná A, Krupová L, Benešová K, Mužík J, Jarkovský J, Búrilová P, Dolanová D, Saibertová S, Klugar M, Krupa M. Challenges in prospective observational studies evaluating pressure ulcer costs: how to price the items correctly. J Wound Care 2023; 32:579-586. [PMID: 37682788 DOI: 10.12968/jowc.2023.32.9.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Pressure ulcers (PUs) are a significant healthcare problem with a negative impact on patients' quality of life and incurring substantial healthcare expenses. Our study aimed to analyse the costs of treating PUs in hospitalised patients in the Czech Republic, in the context of current treatment procedures and price levels, and to pilot-test the detailed methodology developed. METHOD A prospective, observational, non-interventional study was conducted at the Clinic of Anesthesiology, Resuscitation and Intensive Medicine, the Internal Medicine Department and the Surgical Department of the University Hospital Ostrava. The study included all hospitalised patients with a PU from March-May 2021. Data were collected using the hospital information system. A bottom-up, person-based approach to cost analysis was used, based on a comprehensive cost structure using accurate patient-specific consumption records. RESULTS The length of hospitalisations ranged from 1-31 (mean: 12.7) days. The average cost of PU treatment per hospitalisation was calculated at €1579. The average daily cost of PU treatment was €179, including antibiotic therapy (ATB) and €112 without ATB. Most of the costs were associated with ATB (38.6%) and caregivers' time (35.9%). Based on the results, a predictive model was developed to estimate the cost of treating a hospitalised patient with a PU, which could be used in future research to assess the costs of treating these patients. CONCLUSION We have faced many challenges in the methodology of preparation of cost analysis (e.g., how to count amorphous topical agents and sprays, how to properly identify PUs, how to price the positioning aids and mattresses, and how to relate the ATB treatment to the PU). This analysis provides important input for developing a comprehensive and more accurate methodology for monitoring PU costs in hospitalised patients, applicable in clinical practice for inpatient healthcare providers.
Collapse
Affiliation(s)
- Andrea Pokorná
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Krupová
- Department of Dermatology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Klára Benešová
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan Mužík
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jirí Jarkovský
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petra Búrilová
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Dana Dolanová
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simona Saibertová
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miloslav Klugar
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miroslav Krupa
- Faculty of Business Administration, Prague University of Economics and Business, Praha, Czech Republic
| |
Collapse
|
2
|
Dolanová D, Búřilová P, Krupová L, Benešová K, Jarkovský J, Saibertová S, Pokorná A. Mortality related to pressure ulcers in Czech Republic - Analyses of national health registries. J Tissue Viability 2023:S0965-206X(23)00059-1. [PMID: 37198049 DOI: 10.1016/j.jtv.2023.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/28/2023] [Accepted: 05/07/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Pressure ulcers/pressure injuries (PUs/PIs) relate to decreasing quality of life, prolonged hospitalisation, the increased economic cost of care, and increased mortality. That's why this study focused on one of the mentioned factors - mortality. OBJECTIVES The study analyses national data in the Czech Republic to map the mortality phenomenon comprehensively based on data from national health registries. METHOD The retrospective, nationwide cross-sectional data analysis of data collected by the National Health Information System (NHIS) has been provided in the period 2010-2019 with a special focus on 2019. Hospitalisations with PUs/PIs were identified by reporting L89.0-L89.9 diagnosis as a primary or secondary hospitalisation diagnosis. We also included all the patients who died in the given year with an L89 diagnosis reported in 365 days prior the death. RESULTS In 2019, 52.1% of patients with reported PUs/PIs were hospitalised, and 40.8% were treated on an outpatient basis. The most common underlying cause of death mortality diagnosis (43.7%) in these patients was the diseases of the circulatory system. Patients who die in a healthcare facility while hospitalised with an L89 diagnosis generally have a higher category of PUs/PIs than persons who die outside a healthcare facility. CONCLUSION The proportion of patients dying in a health facility is directly proportional to the increasing PUs/PIs category. In 2019, 57% of patients with PUs/PIs died in a healthcare facility, and 19% died in the community. In 24% of patients who died in the healthcare facility, PUs/PIs were reported 365 days before the death.
Collapse
Affiliation(s)
- Dana Dolanová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého náměstí 4, Prague, 128 01, Czech Republic
| | - Petra Búřilová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého náměstí 4, Prague, 128 01, Czech Republic; Department of Public Health, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic
| | - Lenka Krupová
- Department of Dermatology, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava, 708 00, Czech Republic
| | - Klára Benešová
- Institute of Health Information and Statistics, Palackého náměstí 4, Prague, 128 01, Czech Republic
| | - Jiří Jarkovský
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého náměstí 4, Prague, 128 01, Czech Republic
| | - Simona Saibertová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic
| | - Andrea Pokorná
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého náměstí 4, Prague, 128 01, Czech Republic.
| |
Collapse
|
3
|
Vokurka S, Pokorná A, Stryja J, Krupová L, Mezera V, Cvek J, Holečková P, Ston R, Hašková L, Audyová M, Pechačová Z, Šípová S, Jirsová K, Veverková L. Oncology wounds – recommendations for care based on multidisciplinary cooperation. Klin Onkol 2022; 35:408-420. [DOI: 10.48095/ccko2022408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
4
|
Pokorná A, Dolanová D, Benešová K, Búřilová P, Mužík J, Jarkovský J, Krupová L, Baťalík L, Klugarová J, Klugar M. How the COVID-19 pandemic influences the prevalence of pressure injuries in the Czech Republic: A nationwide analysis of a health registry in 2020. J Tissue Viability 2022; 31:424-430. [PMID: 35725785 PMCID: PMC9197563 DOI: 10.1016/j.jtv.2022.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/06/2022] [Accepted: 06/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND COVID-19 significantly influences the overall patient status and, in severe symptomatology, the ability to move and the low oxygenation of the tissue for the ventilated patient in Intensive Care Units (ICU). There is a higher risk for Pressure injuries (PIs) development. OBJECTIVES The nationwide analyses of the National health register aimed to compare the prevalence of PIs reported before the pandemic COVID-19 started and during the pandemic in 2020. METHOD A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist collected by the National Health Information System (NHIS), focusing on the PIs reporting based on the International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs in 2020. The data from the pandemic period of COVID-19 in 2020 were compared to the prevalence of PI cases in the period 2010-2019 in the Czech Republic in all hospitalized patients. RESULTS The total number of admissions for L89 in 2020 was 14,441, of which 1509 (10.4%) also had COVID-19. In the ICU were 4386 admissions, 12.1% of which also had COVID-19. A higher proportion of PIs is observed in patients hospitalized with COVID-19 than in patients without COVID-19 (2.62% vs 0.81%, respectively 1.05% vs 0.46% when standardized to the 2013 ESP = European Standard Population). In patients hospitalized in ICU, 3.68% with COVID-19 had PIs vs 1.42% without COVID-19 had PIs (1.97% vs 0.81% using the 2013 ESP). CONCLUSION The national health registers analyses have proven that the prevalence of PIs was higher among patients hospitalized with the SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Andrea Pokorná
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic; Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic.
| | - Dana Dolanová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic,Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Klára Benešová
- Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Petra Búřilová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic,Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic,Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic,Department of Public Health, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic
| | - Jan Mužík
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic,Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Jiří Jarkovský
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic,Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Lenka Krupová
- Department of Dermatology, University Hospital Ostrava, 17. Listopadu 1790/5, Ostrava, 708 00, Czech Republic
| | - Ladislav Baťalík
- Department of Public Health, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic,Department of Rehabilitation, University Hospital Brno, Jihlavska 20, Brno, 625 00, Czech Republic
| | - Jitka Klugarová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic,Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic,Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic
| | - Miloslav Klugar
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic,Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic,Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic
| |
Collapse
|
5
|
Búřilová P, Pokorná A, Benešová K, Mužík J, Klugar M, Krupová L, Dolanová D, Saibertová S, Beeckman D. A ten-year follow-up of the prevalence of pressure injuries in the Czech Republic: Analysis of the National Registry. Int Wound J 2022; 19:1870-1877. [PMID: 35352481 PMCID: PMC9615265 DOI: 10.1111/iwj.13793] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 02/02/2023] Open
Abstract
The study aims to follow up on the analysis of Pressure injuries (PIs) prevalence conducted between 2007 and 2014 and after the new methodological requirements for PIs surveillance establishment at the national level. A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist was collected by the National Health Information System (NHIS). The International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs were used in the period 2010-2019. A total of 264 442 records of patients with diagnoses of L89.0-L89.9 were identified from 2010 to 2019 (26 444 patients per year on average). The numbers are increasing every year, and there is a 40% increase between 2010 and 2019. When comparing recorded PIs, the percentage of PIs occurrence in category I decreased, and the number of PIs in category IV increased in the second analysed period. Still, in absolute numbers, there is an increase across all categories. The age of patients with recorded PIs also rose slightly in the second analysed period. We have proven the PIs prevalence increase in an ageing population.
Collapse
Affiliation(s)
- Petra Búřilová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic,Department of Public HealthMasaryk University, Faculty of MedicineBrnoCzech Republic
| | - Andrea Pokorná
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Klára Benešová
- Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Jan Mužík
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Miloslav Klugar
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic,Czech National Centre for Evidence‐Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of ExcellenceMasaryk University GRADE Centre, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
| | - Lenka Krupová
- Department of DermatologyUniversity Hospital OstravaOstravaCzech Republic
| | - Dana Dolanová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Simona Saibertová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary CareGhent UniversityGhentBelgium,School of Health SciencesÖrebro UniversityÖrebroSweden,School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI)University of Medicine and Health SciencesDublinIreland,Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark,School of Nursing and MidwiferyMonash UniversityClaytonAustralia
| |
Collapse
|
6
|
Cvek J, Vokurka S, Hajnová Fukasová E, Krupová L, Šimonová P, Žemličková M, Jedličková M, Jirsová K, Šlampa P, Doležel M, Hynková L. Recommendation for preventive and therapeutic skin care of patients undergoing radiotherapy. Klin Onkol 2021; 34:481-487. [PMID: 34911335 DOI: 10.48095/ccko2021481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Radiation dermatitis is a very common reaction to radiotherapy, affecting approx. 95% of patients with varying intensity. It is crucial to minimize its side effects. The working group that prepared this document includes physicians, nurses, representatives of the Society for Radiation Oncology, Biology and Physics of the Czech Medical Association of J. E. Purkyně, the Supportive Treatment and Care Section of the Czech Society for Oncology of the Czech Medical Association of J. E. Purkyně, the Czech Wound Management Association, the Oncological Section of Czech Association of Nurses, and dermatologists. The document has been approved by the committees of these associations. PURPOSE Recommendation for preventive and therapeutic skin care of patients undergoing radiotherapy in the Czech Republic.
Collapse
|
7
|
Krupová L, Pokorná A. Quality of life in patients with non-healing wounds, with particular focus on assesment tools - a literature review. Cent Eur J Nurs Midw 2020. [DOI: 10.15452/cejnm.2020.11.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|