Cost-effectiveness of subepidermal moisture measurement to prevent hospital-acquired pressure ulcers.

IF 1.5 4区医学 Q3 DERMATOLOGY

Journal of wound care Pub Date : 2025-07-02 DOI:10.12968/jowc.2024.0427

John Posnett, Joe Moss, Lewis Michaelwaite

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引用次数: 0

Abstract

Objective: A pressure ulcer (PU) develops initially at the cellular level, progressing through damage to subepidermal cells and surrounding tissues before it becomes visible on the surface of the skin. Changes in subepidermal moisture (SEM) are a biomarker for the early stages of PU development. The objective of this study was to evaluate the cost-effectiveness of adding measurement of SEM to current standard of care (SoC), with the aim of reducing the incidence of hospital-acquired pressure ulcers (HAPUs).

Method: A decision-tree model was developed. Outcomes were the incidence of HAPUs, quality-adjusted life-years (QALYs) and costs to the UK National Health Service (NHS) at 2022/23 prices. The effects of parameter uncertainty were tested in univariate and probabilistic sensitivity analysis.

Results: In a typical NHS acute hospital with 480 beds, the addition of SEM assessment as an adjunct to SoC is expected to reduce the incidence of HAPUs by 32.9% and lead to a cost saving of £26.53 per admission. The probability that adjunctive SEM is cost-effective at a threshold of £30,000 per QALY is 69%.

Conclusion: SEM assessments make it possible to implement early and anatomy-specific interventions which can improve the effectiveness of PU prevention and reduce healthcare costs.

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皮下湿度测量预防医院获得性压疮的成本效益。

目的：压疮（PU）最初在细胞水平发展，在皮肤表面可见之前，通过对表皮下细胞和周围组织的损伤进展。皮下湿度（SEM）的变化是PU发育早期阶段的生物标志物。本研究的目的是评估在现行护理标准（SoC）中增加SEM测量的成本效益，目的是减少医院获得性压疮（hapu）的发生率。方法：建立决策树模型。结果是hapu的发生率、质量调整生命年（QALYs）和英国国家卫生服务（NHS）以2022/23年价格计算的成本。在单变量和概率敏感性分析中检验了参数不确定性的影响。结果：在一个典型的480张床位的NHS急症医院，增加SEM评估作为SoC的辅助，预计将减少hapu的发生率32.9%，并导致每次住院费用节省26.53英镑。在每个QALY 30,000英镑的门槛下，辅助SEM具有成本效益的概率为69%。结论：扫描电镜评估使实施早期和解剖特异性干预成为可能，可以提高PU预防的有效性并降低医疗成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.