Document Detail

Evaluating the effect of the new incentive system for high-risk pressure ulcer patients on wound healing and cost-effectiveness: a cohort study.
MedLine Citation:
PMID:  19748617     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effectiveness and cost-effectiveness of new incentive system for pressure ulcer management, which focused on skilled nurse staffing in terms of rate of healing and medical costs. DESIGN, SETTING AND PARTICIPANTS: A prospective cohort study included two types of groups: 39 institutions, which introduced the new incentive system, and 20 non-introduced groups (control). Sixty-seven patients suffering from severe pressure ulcers in the introduced group and 38 patients in the non-introduced group were included. Wound healing and medical costs were monitored weekly for three weeks by their skilled nurses in charge. MAIN OUTCOME MEASURES: Healing status and related medical costs. RESULTS: The introduced group showed significantly higher rate of healing compared with the control group at each weekly assessment. Multiple regression analysis revealed that the introduction of the new incentive system was independently associated with the faster healing rate (beta=3.44, P<.001). The budget impact analysis demonstrated that introducing this system could reduce cost of treating severe pressure ulcers by 1.776 billion yen per year. CONCLUSIONS: The new incentive system for the management of pressure ulcers, which focused on staffing with skilled nurses can improve healing rate with reduced medical cost.
Hiromi Sanada; Gojiro Nakagami; Yuko Mizokami; Yukiko Minami; Aya Yamamoto; Makoto Oe; Toshiko Kaitani; Shinji Iizaka
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Multicenter Study     Date:  2009-09-12
Journal Detail:
Title:  International journal of nursing studies     Volume:  47     ISSN:  1873-491X     ISO Abbreviation:  Int J Nurs Stud     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-05-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400675     Medline TA:  Int J Nurs Stud     Country:  England    
Other Details:
Languages:  eng     Pagination:  279-86     Citation Subset:  IM; N    
Copyright Information:
Copyright 2009 Elsevier Ltd. All rights reserved.
Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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MeSH Terms
Analysis of Variance
Clinical Protocols
Cost of Illness
Cost-Benefit Analysis
Japan / epidemiology
National Health Programs / organization & administration*
Nursing Staff, Hospital / organization & administration
Personnel Staffing and Scheduling / organization & administration
Pressure Ulcer / economics,  etiology,  prevention & control*
Program Evaluation
Prospective Studies
Regression Analysis
Reimbursement, Incentive / organization & administration*
Risk Factors
Severity of Illness Index
Wound Healing*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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