OBJECTIVES: Dutch burn care has started implementing value-based health care (VBHC) to maximize patient perceived outcomes per unit costs, due to complex and expensive care. With the Quality Cost Indicator (QCI) model, the patient perceived health outcomes per unit costs can be calculated. This study aims to externally validate the QCI model for burn care, and to provide insights regarding outcomes and costs of specialized burn care.

METHODS: The QCI model was redeveloped into the Burn Care- QCI (BC-QCI) model by a project team, consisting of healthcare managers, burn survivors and burn care professionals. The team selected in an iterative process the health outcome indicators of burn care: admission period, complications, wound infection, discharge destination, predicted mortality and quality of life. Next, threshold values for success versus failure per health outcome indicator were established. The total costs of burn care were calculated separately for each patient, which included direct medical costs, and outpatient care costs. The model was tested in a cohort of burn patients, with a one-year follow-up period. Adult patients with an admission due to acute burn injuries in one of the three Dutch burn centers between January 2020 and June 2023, were included. Data was derived from the Dutch Burn Repository R3 and the Burn centers Outcomes Registry the Netherlands.

RESULTS: The BC-QCI was tested in 1039 adult burn patients. 57% of the population successfully achieved all health outcome indicators. Almost all patients (99%) achieved the outcome ‘predicted mortality’. The most failed health outcome indicator was due to a prolonged admission period. Only 66% of the population achieved this health outcome indicator. Further results on outcomes and costs will be presented at the conference.

CONCLUSIONS: By developing a BC-QCI model, healthcare providers and management can monitor the performance of the burn care path at the hospital level.