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Retrospective matched cohort study of incidence rates and excess length of hospital stay owing to pressure injuries in an Asian setting.
Graves, Nicholas; Maiti, Raju; Aloweni, Fazila Abu Bakar; Yi Zhen, Ng; Yuh, Ang Shin; Bishnoi, Priya; Chong, Tze Tec; Carmody, David; Harding, Keith.
Afiliación
  • Graves N; Health Services and Systems Research Duke-NUS Medical School Singapore Singapore.
  • Maiti R; Centre for Quantitative Medicine Duke-NUS Medical School Singapore Singapore.
  • Aloweni FAB; Singapore General Hospital Singapore Singapore.
  • Yi Zhen N; Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR) Singapore Singapore.
  • Yuh AS; Singapore General Hospital Singapore Singapore.
  • Bishnoi P; Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR) Singapore Singapore.
  • Chong TT; Singapore General Hospital Singapore Singapore.
  • Carmody D; Singapore General Hospital Singapore Singapore.
  • Harding K; Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR) Singapore Singapore.
Health Care Sci ; 2(2): 82-93, 2023 Apr.
Article en En | MEDLINE | ID: mdl-38938768
ABSTRACT

Background:

Little is known about stage 1 and 2 pressure injuries that are health care-acquired. We report incidence rates of health care-acquired stage 1 and stage 2 pressure injuries, and, estimate the excess length of stay using four competing analytic methods. We discuss the merits of the different approaches.

Methods:

We calculated monthly incidence rates for stage 1 and 2 health care-acquired pressure injuries occurring in a large Singapore acute care hospital. To estimate excess stay, we conducted unadjusted comparisons with a control cohort, performed linear regression and then generalized linear regression with a gamma distribution. Finally, we fitted a simple state-based model. The design for the cost attribution work was a retrospective matched cohort study.

Results:

Incidence rates in 2016 were 0.553% (95% confidence interval [CI] 0.55, 0.557) and 0.469% (95% CI 0.466, 0.472) in 2017. For data censored at 60 days' maximum stay, the unadjusted comparisons showed the highest excess stay at 17.68 (16.43-18.93) days and multi-state models showed the lowest at 1.22 (0.19, 2.23) days.

Conclusions:

Poor-quality methods for attribution of excess length of stay to pressure injury generate inflated estimates that could mislead decision makers. The findings from the multi-state model, which is an appropriate method, are plausible and illustrate the likely bed-days saved from lowering the risk of these events. Stage 1 and 2 pressure injuries are common and increase costs by prolonging the length of stay. There will be economic value investing in prevention. Using biased estimates of excess length of stay will overstate the potential value of prevention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Health Care Sci Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Health Care Sci Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido