Elsevier

Burns

Volume 35, Issue 5, August 2009, Pages 738-745
Burns

The direct hospitalisation costs of paediatric scalds: 2-Year results of a prospective case series

https://doi.org/10.1016/j.burns.2008.12.004Get rights and content

Abstract

Objective

To reveal the characteristic and distribution of length of hospital stay (LOS) and direct hospitalisation costs of paediatric scald.

Methods

A prospective case series observation was performed from January 2005 to December 2006 at the Burn Center, Changhai Hospital, Shanghai, China. The information, such as demographics, clinical diagnosis and treatments since admission, of the paediatric scald patients included in the series was recorded. The direct cost of a treatment event was recorded into the price system when it was incurred. All cost data were summarised on completion of the study. The distribution of LOS and the hospitalisation costs were recorded by gender, age, total burn area, depth of burn, blood transfusion and patterns of treatment. Mann–Whitney signed-rank test was used to assess the differences between continuous, non-normally distributed variables, and multiple linear regression was used to model LOS and direct hospitalisation costs. Statistical analyses were undertaken with SPSS 15.0 statistical software.

Results

Patients aged 3 years or less accounted for more than half of the total LOS and hospitalisation costs, patients with burn area less than 10%TBSA (total burn surface area) accounted for more than 70% of the total LOS and more than half of the hospitalisation costs and patients with second-degree burn accounted for more than 78% of the total LOS and hospitalisation costs. Depth of burn, area of burn, patterns of treatment and blood transfusion were independent predictors of LOS; whereas LOS, area of burn and blood transfusion were independent predictors of hospitalisation costs.

Conclusion

Paediatric scalds have particular characteristics in terms of distribution of LOS and direct hospitalisation costs and the factors influencing them. The data presented in this study should assist burn care practitioners and hospital epidemiologists estimate and compare the economic burden of paediatric burns at other institutions; it may also be useful in resource allocation and cost-effectiveness analysis of treatment versus prevention strategies.

Section snippets

Patients and treatments

We conducted a prospective case series observation from January 2005 to December 2006 at the Burn Center, Changhai Hospital, Shanghai, China. Paediatric patients were admitted according to the following criteria:

  • (a)

    >5%TBSA (total burn surface area),

  • (b)

    deep second-degree burns and/or third-degree burns,

  • (c)

    burns with complications (wound inflammation, infection, shock, combined injury, poisoning and inhalation injury), and

  • (d)

    burns to specialist areas (face, hands, feet, perineum and major joints).

All the

Sociodemographic and clinical characteristics

During the study period, 178 patients aged 0–14 years were admitted to the Burn Center; of these, 71.91% (128 of the 178) suffered from acute burn injury, and 88.28% (113 of the 128) of the acute burn injuries were scalds; there were no cases of mortality before discharge. Of the 113 patients included, 55.75% were boys and 44.25% were girls (male/female ratio was 1.26:1), the distribution of age (mean ± standard deviation (S.D.): 4.08 ± 2.56, median age: 3 years and range: 2–13 years)) and total

Discussion

In this study, we analysed the paediatric scalds data from our department and described the characteristics of their LOS and hospitalisation costs and the factors that impacted them. In this case series, we had found that patients aged 3 years or less accounted for more than half of the total LOS and total hospitalisation costs, patients with burn area less than 10%TBSA accounted for more than 70% of the total LOS and more than half of the total hospitalisation costs, and patients with

Acknowledgements

We thank the nursing team of the Burn Center and staff members of Department of Information for their help with data collection, and thank professor Zhang Luo-Man for his advice on statistics.

Source of funding: This work was financially supported by Key Project of National Natural Science Foundation of China (No. 30730091), National Natural Science Foundation of China (No. 30571921) and special funds from Shanghai Health Bureau (No. 05III007).

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    These authors contributed equally to this work.

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