The economic analysis was carried out alongside a clinical study. The time horizon was from admittance until discharge from hospital. The authors stated that the perspective of the hospital was considered.
The clinical data came from a prospective cohort study, namely the Purse Value study, which was carried out at two teaching hospitals in the Netherlands. These two hospitals used different approaches for the prevention and treatment of pressure ulcers. In the technical group, there were 618 patients, with a mean age of 64.8 years and 43.4% were female. In the human-intervention group, there were 822 patients, with a mean age of 66 years and 52.1% were female. The incidence of pressure ulcers was the key endpoint.
Monetary benefit and utility valuations:
Measure of benefit:
There was no summary measure of benefit. The incidence of pressure ulcers was the key clinical endpoint.
The economic analysis included the costs of time spent by the nursing staff, use of materials, therapeutic interventions, general nutrition, and consultation with a specialised wound care nurse, dietician, or medical specialist. These were valued for four main categories: repositioning, mobilisation, wound care, and resources (special beds, mattresses, dressings, nutritional supplements, and ointments). The resource use data were estimated using a specific standardised case report form with a subgroup of patients who differed slightly from the overall clinical study patients. For prevention there were 94 patients with technical and 55 with human intervention, and for treatment there were 26 with technical and 48 with human intervention. The unit costs were reported and they were based on hospital purchase prices and Dutch national health system purchases. All costs were in Euros (EUR).
Analysis of uncertainty:
Alternative analyses considered variations in the cost of nursing time, the cost of materials, and the number of patients at risk of pressure ulcers.