Dr Dinuksha De Silva1, Dr Aruna Wijewardana1, Dr John Vandervord1
1Royal North Shore Hospital
The treatment of an extensive burn injury in the acute and sub-acute settings can be costly (Ahn & Maitz, 2012). Severe burns often necessitate protracted hospital stays, heavy utilisation of resources and mobilisation of multidisciplinary teams. While it is agreed that burns care is costly, there is very little existing literature that accurately quantifies this financial burden (Ahn & Maitz, 2012). This report describes the experience of a dedicated Sydney burns centre in managing a patient with extensive (>80% total body surface area) chemico-thermal burn wounds, with a focus on the cost of the hospital care.
We will outline the progress of treatment during the course of the 170-day hospital admission; the setting of care transitioned from the Intensive Care Unit to the Severe Burns Unit. Surgical management was required throughout, including debridements, application of specialised dressings and split-thickness skin grafting in the context of limited autograft availability. The resource-burden was intensified by medical challenges in the sub-acute period. In particular, chronic anaemia and recurrent infections necessitated blood products, pharmacotherapy, investigations and re-admissions to ICU. Multidisciplinary staff were involved with the aims of regaining mobility, functional independence, and psychiatric health.
This report will provide a breakdown of the major contributers to the healthcare cost. We will present, to our knowledge, one of the first reported cost vs funding analyses in Australian burn care.
1. Ahn, CS & Maitz, PKM 2012, ‘The true cost of burn’, Burns, vol. 38, no. 7, pp. 967–974.
Dr De Silva is a resident medical officer who has worked with the Severe Burns Unit and Plastic Surgery Department at Royal North Shore Hospital. As a medical student he was selected to travel to Fiji as part of a surgical outreach program run by Interplast. He has a special interest in Burns and Reconstructive Surgery.