The cost of Self Immolation – 20 years of data from RBWH

Dr Mikaela Seymour1, Dr  Andrew  Maurice1, Dr Jason  Brown1

1Royal Brisbane and Womens Hospital, Stuart Pegg Burns Centre, Brisbane, Australia

Abstract:

Self immolations are usually very large burns, difficult to treat, and use a large portion of health resources. The patients generally have psychiatric co-morbidities which complicate optimal care and follow up. The severe nature of these burns typically means they are over-represented in the workload of burns staff, and in the budget of Burns units. This poster will examine the cost of self immolation in a large Tertiary Burns referral centre, demonstrating the large proportionate spending on Self immolation compared to accidental burns.

The burns unit at the Royal Brisbane and Women’s Hospital in total, admitted or performed day surgery on 5815 patients with mean 10% TBSA burns during the last 20 years. Self immolations constituted 125 (2%) of these admissions, with a mean Total Body Surface Area Burn of 45%, constituting 11% of all TBSA treated over this time period.

Analysis of all Intensive Care Unit admissions for burns patients was performed and 24% of the ICU bed days were found to be Self immolations. The average cost of a day in ICU was between AUD $2670- 9852.

Although the care of Self immolations usually involves long admissions (and re-admissions), frequent outpatients visits, refractory mental illness, significant allied health input and resources, to estimate the entirety of health expenditure on self immolation is extremely difficult.

This poster examines the cost to the health service of the index admission per ICU and ward bed day required for Self immolators, with a break down comparison per Total Body Surface Area to accidental burns. It concludes that a large portion of health resources is being used on a small portion of admissions, challenging the audience ethically to consider their current treatment of Self immolations and foster a greater understanding of this burns populations impact on our health service.


Biography:

Dr Mikaela Seymour is a General Surgery PHO at the Sunshine Coast University Hospital. She has previously worked at the Royal Brisbane and Womens Stuart Pegg Burns Centre.