Financial and Clinical Risk Evaluation of Pressure Injuries in US Hospitals: A Business Case for Initiating Quality Improvement
Au, Y.; Wang, S.C.
Wounds a Compendium of Clinical Research and Practice 31(5): 123-126
2019
ISSN/ISBN: 1044-7946 PMID: 31033454 Document Number: 699455
Pressure injuries (PIs) are a serious, avoidable condition that affect many patients during hospital stays. Yet, to date, there is no comprehensive assessment of the financial and clinical risks of PIs. This study evaluates the cost of treatment, impact of reimbursement policies, and clinical consequences of PIs for US hospitals. A financial and clinical calculator was created to estimate the impact of PI prevention using a traditional literature review to drive assumptions. Two drivers of hospital revenue loss resulting from PIs were identified: nonpayment for PI treatment by health insurance providers and personal injury litigation. Increased hospital length of stay (LOS) and patient mortality associated with PIs further contributed to negative consequences. For an average 160-bed hospital, the authors estimated an annual total financial risk of $5.97 million, 911 days added to LOS, and 16.4 deaths related to avoidable PIs. Results of this analysis will be useful for health care organizations implementing quality improvement initiatives and new technologies, such as digital wound care management systems, to reduce the prevalence of PIs, thereby protecting patients and mitigating financial and clinical risks.