The cost of pressure ulcers in the UK

Objective: to estimate the annual cost of treating pressure ulcers in the UK. Design: costs were derived from a bottom-up methodology, based on the daily resources required to deliver protocols of care reflecting good clinical practice. Setting: health and social care system in the UK. Subjects: patients developing a pressure ulcer. Methods: a bottom-up costing approach is used to estimate treatment cost per episode of care and per patient for ulcers of different grades and level of complications. Also, total treatment cost to the health and social care system in the UK. Results: the cost of treating a pressure ulcer varies from pound1,064 (Grade 1) to pound10,551 (Grade 4). Costs increase with ulcer grade because the time to heal is longer and because the incidence of complications is higher in more severe cases. The total cost in the UK is pound1.4-pound2.1 billion annually (4% of total NHS expenditure). Most of this cost is nurse time. Conclusions: pressure ulcers represent a very significant cost burden in the UK. Without concerted effort this cost is likely to increase in the future as the population ages. To the extent that pressure ulcers are avoidable, pressure damage may be indicative of clinical negligence and there is evidence that litigation could soon become a significant threat to healthcare providers in the UK, as it is in the USA.