The Cost of Illness of Pressure Ulcers in the Netherlands

OBJECTIVE: To conduct a cost-of-illness study of pressure ulcers in the Netherlands for different care settings, including home care, nursing homes, general hospitals, and university hospitals. DESIGN: A cost-of-illness study was conducted based on prevalence figures and expert opinion. A differential cost study approach was used, distinguishing among the 4 stages of pressure ulcer severity and the different care settings. To obtain expert opinion, structured interviews were conducted with pressure ulcer experts who were chosen randomly from the membership of the Dutch Society of Pressure Ulcer Experts. Information was gathered on volume of care parameters for each pressure ulcer stage, including personnel, extra days of care, and use of special beds and medical materials. Experts were asked to estimate the percentage of patients for which each care parameter was considered relevant; low and high estimates of each figure were given to determine the range of the calculations. Cost estimates were obtained from Dutch guidelines for cost calculations in health care, then converted to US dollars. SETTING: Home care, nursing homes, general hospitals, and university hospitals in the Netherlands. PARTICIPANTS: Experts on pressure ulcer management working in the different care settings. MAIN OUTCOME MEASURE: Cost-of-illness of pressure ulcers, converted to US dollars. MAIN RESULTS: The cost-of-illness of pressure ulcers ranged from a low estimate of 362 million to a high estimate of 2. 8 billion. The most conservative estimate is approximately 1% of the total Dutch health care budget. CONCLUSION: The cost-of-illness of pressure ulcers in the Netherlands is considerable.