Cost of Medications in Patients Admitted to a Burn Center

Abstract

Background: Few studies have examined the cost associated with burn patients, and those which have been conducted have generally focused on overall hospitalization costs associated with these patients. No studies to date have examined the overall drug utilization and costs of medications used in the treatment of burn patients.

Objective: To describe the pattern of drug utilization and associated costs for the treatment of patients admitted to the Ross Tilley Burn Centre at Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada.

Methods: A retrospective chart review was conducted based on the medical records of 30 adult patients (>18 years old) consecutively admitted to the burn center between 1 August 1999 and 30 September 1999. Charts were examined to determine drugs administered, doses and duration of use. Medications administered in the operating room were excluded from the analysis. Drug costs were calculated using hospital acquisition costs (1999 Canadian dollars [$Can]) and medications were categorized by pharmacological class according to the American Hospital Formulary Service. Demographic information for the patients was extracted from the burn center’s database. The economic analysis was performed from the perspective of the hospital burn center. A descriptive statistical analysis was completed for all variables; the Pearson correlation coefficient was used to examine the relationship between certain variables. A sensitivity analysis was conducted to examine the impact of patient subgroups on certain variables

Results: Of the 28 patients included in the analysis, 19 were admitted with acute burn injuries, two with toxic epidermal necrolysis and seven for post-burn reconstructive surgery. Patients admitted for acute burns or toxic epidermal necrolysis had the highest associated drug costs. On average, patients received 13 different drugs representing four different pharmacological categories. The mean daily drug cost per patient was $Can18.39 and the mean expenditure per admission was $Can792.97. Opioid analgesics and sedatives accounted for the largest expenditure (50.9%), followed by anti-infective agents (23.4%). For patients admitted with acute burns, there was a good correlation between daily drug costs and mortality risk (r = 0.82, p < 0.001). The findings from this study group were used to extrapolate annual expenses for medications in the burn center and these were estimated to exceed $Can280 300 in 2003.

Conclusion: The findings of this retrospective analysis serve to elucidate the patterns of drug utilization within a population of burn patients and confirm the significant impact of a burn center on an institution’s drug expenditure.