OBJECTIVE: Pressure ulcers (PUs) are a significant healthcare problem with a negative impact on patients' quality of life and incurring substantial healthcare expenses. Our study aimed to analyse the costs of treating PUs in hospitalised patients in the Czech Republic, in the context of current treatment procedures and price levels, and to pilot-test the detailed methodology developed. METHOD: A prospective, observational, non-interventional study was conducted at the Clinic of Anesthesiology, Resuscitation and Intensive Medicine, the Internal Medicine Department and the Surgical Department of the University Hospital Ostrava. The study included all hospitalised patients with a PU from March-May 2021. Data were collected using the hospital information system. A bottom-up, person-based approach to cost analysis was used, based on a comprehensive cost structure using accurate patient-specific consumption records. RESULTS: The length of hospitalisations ranged from 1-31 (mean: 12.7) days. The average cost of PU treatment per hospitalisation was calculated at €1579. The average daily cost of PU treatment was €179, including antibiotic therapy (ATB) and €112 without ATB. Most of the costs were associated with ATB (38.6%) and caregivers' time (35.9%). Based on the results, a predictive model was developed to estimate the cost of treating a hospitalised patient with a PU, which could be used in future research to assess the costs of treating these patients. CONCLUSION: We have faced many challenges in the methodology of preparation of cost analysis (e.g., how to count amorphous topical agents and sprays, how to properly identify PUs, how to price the positioning aids and mattresses, and how to relate the ATB treatment to the PU). This analysis provides important input for developing a comprehensive and more accurate methodology for monitoring PU costs in hospitalised patients, applicable in clinical practice for inpatient healthcare providers.
- MeSH
- ambulantní zařízení MeSH
- dekubity * terapie MeSH
- hnisání MeSH
- kvalita života MeSH
- lidé MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Kompresivní terapie je zlatým standardem léčby otoků a ulcerací venózní etiologie. Pro úspěšnou léčbu je důležité adekvátní zacházení s kompresivními materiály ze strany zdravotnických profesionálů a adherence pacienta k terapii. Edukace vedoucí ke správnému používání kompresivních prostředků spolu s vysvětlením onemocnění podporuje dodržování léčby. Je nutné zvolit takovou variantu kompresivní terapie, kterou pacient toleruje a dokáže ji správně použít. Důležité je zohlednit životní styl pacientů, edukovat je a pravidelně komunikovat včetně kontroly aplikace.
Compression therapy is the gold-standard treatment for edema and leg ulcers of venous etiology. Adequate handling of compression materials by medical professionals and patient adherence to therapy is important for successful treatment. Education leading to the correct use of compression materials and an explanation of the disease promotes adherence to treatment. Choosing a compression therapy option that the patient tolerates and can use correctly is essential. It is important to consider the lifestyle of patients, educate them and communicate regularly, including checking the application.
- MeSH
- adherence pacienta MeSH
- bércové vředy * terapie MeSH
- kompresní obvazy * MeSH
- lidé MeSH
- žilní insuficience komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Radiační dermatitida je velmi častou reakcí při radioterapii, postihuje s různou intenzitou přibližně 95 % pacientů. Při závažném průběhu může mít významný dopad na kvalitu života. Vhodné použití klinicky prověřených produktů umožňuje ochraňovat pokožku pacienta a dosahovat velmi dobrých výsledků během léčby kožních reakcí. Praktičtí lékaři mohou významně přispět k naplnění potřeb pacientů, ujistit je, podpořit, edukovat případně doplnit informace. Existující vztahy praktických lékařů s jejich pacienty jsou dobrým předpokladem k tomu, aby se bez obav mohli doptat a poradit. Znalost aktuálních postupů pomůže jak konzistentním informacím pro pacienta a jeho edukaci, tak rozpoznání, kdy řešit obtíže a kdy doporučit pacienta ke specialistovi. Přehledový článek je redukovanou verzí dokumentu Doporučení pro preventivní a léčebnou péči o kůži pacientů podstupujících radioterapii zaměřenou na potřeby lékařů poskytující primární péči.
Radiation dermatitis is a very common reaction in radiotherapy, affecting approximately 95 % of patients with varying intensity. In severe cases, it can significantly impact the quality of life. Appropriate use of clinically proven products protects the patient's skin and achieves excellent results during the treatment of skin reactions. General practitioners can significantly contribute to meeting patients' needs, reassuring them, supporting them, educating them, or supplementing information. Existing GP relationships with their patients are a good precondition for them to be able to inquire and advise without fear. Knowledge of current procedures will help provide consistent information for the patients and their education and recognize when to solve problems and when to recommend the patient to a specialist. The review article is a reduced version of the document Recommendation for preventive and therapeutic skin care of patients undergoing radiotherapy focused on the needs of primary care physicians.
BACKGROUND: Pressure ulcers/pressure injuries (PUs/PIs) relate to decreasing quality of life, prolonged hospitalisation, the increased economic cost of care, and increased mortality. That's why this study focused on one of the mentioned factors - mortality. OBJECTIVES: The study analyses national data in the Czech Republic to map the mortality phenomenon comprehensively based on data from national health registries. METHOD: The retrospective, nationwide cross-sectional data analysis of data collected by the National Health Information System (NHIS) has been provided in the period 2010-2019 with a special focus on 2019. Hospitalisations with PUs/PIs were identified by reporting L89.0-L89.9 diagnosis as a primary or secondary hospitalisation diagnosis. We also included all the patients who died in the given year with an L89 diagnosis reported in 365 days prior the death. RESULTS: In 2019, 52.1% of patients with reported PUs/PIs were hospitalised, and 40.8% were treated on an outpatient basis. The most common underlying cause of death mortality diagnosis (43.7%) in these patients was the diseases of the circulatory system. Patients who die in a healthcare facility while hospitalised with an L89 diagnosis generally have a higher category of PUs/PIs than persons who die outside a healthcare facility. CONCLUSION: The proportion of patients dying in a health facility is directly proportional to the increasing PUs/PIs category. In 2019, 57% of patients with PUs/PIs died in a healthcare facility, and 19% died in the community. In 24% of patients who died in the healthcare facility, PUs/PIs were reported 365 days before the death.
- MeSH
- dekubity * epidemiologie MeSH
- hnisání MeSH
- kvalita života MeSH
- lidé MeSH
- průřezové studie MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Klíčová slova
- pergamenová kůže, International Skin Tear Advisory Panel (STAP), M.O.I.S.T. - koncept pro léčbu chronických ran,
- MeSH
- gely MeSH
- hojení ran MeSH
- kůže patologie MeSH
- lacerace farmakoterapie ošetřování terapie MeSH
- obvazy MeSH
- rány a poranění farmakoterapie ošetřování terapie MeSH
- výsledek terapie MeSH
- Publikační typ
- kazuistiky MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
