Dr Dylan Prunster1, Dr Peter Meier1, Mr Graeme Mcleoud1, Dr Helen Douglas1, Dr Anna Goodwin-Walters1
1Fiona Stanley Hospital – State Burns Service of Western Australia , Perth, Australia
Deliberate self-harm burns (DSHB) constitute roughly 4% of admission to burns units worldwide. Although relatively uncommon in Australia, the incidence is reportedly higher in Asian and African ethnicities, associated with cultural, religious beliefs, and in patients with psychiatric comorbidities (Mason et al., 2017). The significant psychiatric comorbidities linked with DSHB are associated with increased morbidity and mortality, with the treatment of the burn often taking priority over management of their psychological illness (Mason et al., 2017). This is further compounded by the increasing public health pressures of a significantly under-resourced and funded mental health sector. The aim of our audit was to assess the incidence and financial cost of DSHB related admissions in the Western Australian Burns Service.
Materials & Methods
Data were retrospectively collected on 102 consecutive patients admitted with DSHB between 2015 and 2021 from the Western Australia State Burns Centre database for analysis in this audit. The patients’ demographics, total burns surface area (TBSA), length stay (LOS) and intensive care admission (ICU) were analysed.
During the audit period, a total of 55 (19 male, 36 female) patients were admitted 119 times due to DSHB. The average TBSA was 5.9%, the average length of admission was seven days, 52 patients had a psychiatric diagnosis, and 7 patients required ICU admission. The average cost of each admission was $34,730 and the total costs for this patient cohort totalled $3,543,469.
DSHB constitute a significant morbidity and financial burden to the community and the public health system in Western Australia. Despite the focus shifting in recent times to the impact and strain that under-resourced mental health services place on our public health system, we have yet to institute strategies and resources to mitigate the detrimental effect of DSHB related hospital admissions (AIHW, 2014; Caine et al., 2016).
Dr Dylan Prunster is a surgical service registrar working within the West Australian Health Department with an interest in Plastic and Reconstructive Surgery. He obtained his primary medical qualification from the University of Western Australia and subsequently undertook an internship and residency at Royal Perth Hospital.