OBJECTIVES

: Existing evidence shows that hospital-acquired pressure ulcers lead to poor health outcomes and result in additional costs of up to $70,000 per patient because of high treatment costs and extended hospital stays. However, current studies may not adequately adjust for differences in health and disease status between patients who do and do not develop pressure ulcers during their hospital stay. This study estimated the cost of pressure ulcers while improving controls for patient comorbidities and procedures.

METHODS

: The study used data from 21,043 inpatient admissions from 2018 Truven Health Marketscan Commercial Claims and Encounters. A Jaccard dissimilarity score was employed to cluster patients with similar demographics, disease, and treatment status. The incremental cost of pressure ulcers was determined by calculating the difference in average cost of pressure ulcer and non-pressure ulcer patients within each cluster.

RESULTS

: Examining five different clustering scenarios showed that there is heterogeneity in the impact of pressure ulcers on patients’ costs. The average difference in cost for pressure ulcer and control patients in a cluster varied between $0 and $96,000. In all iterations, the additional total cost of pressure ulcers was positive; the average additional cost per pressure ulcer patient varied from $4,400 to $24,000 depending on the number of clusters into which the data is grouped.

CONCLUSIONS

: Previous research has shown a wide variance in the estimated cost of pressure ulcers. Our results further support this and suggest that the impact of pressure ulcers on costs varies with complex interaction of comorbidities, procedures, and patient characteristics. Further studies are needed to identify the comorbidities, procedures, and patient characteristics for which pressure ulcers have the greatest impact on patient costs and inform effective nutrition interventions to reduce the incidence of pressure ulcers and its economic burden.