PIT22 UNDERSTANDING PATIENT JOURNEY IN TERMS OF HEALTHCARE RESOURCE UTILIZATION (HCRU) AND COST OF CARE AMONG PATIENTS WITH THERMAL BURNS AND AUTOGRAFT IN A LARGE MANAGED CARE POPULATION

Abstract

Autograft is included in the current standard of care for severe burns; however, little is known about economic outcomes in this population. This study aimed to assess the real-world HCRU and cost of care among patients who were treated with autograft during an inpatient stay for their thermal burns. The HealthCore Integrated Research Database (HIRD®) was used to identify thermal burn patients receiving a first inpatient autograft between 01/01/2011 and 04/30/2016. The first admission date was regarded as the index date. One-year pre- and two-year post-index continuous enrollment were required. Patient demographics, clinical characteristics, HCRU, and total cost were presented. Of 371 identified patients, mean age was 39.6 years (SD=21.86), and 67.1% were males. The majority of burn sites were in upper limb (67.1%) or lower limb (64.2%); 93.3% of patients had third degree or deep third degree burns. Approximately 43.2% had at least 10% total burn surface area (TBSA). The average length of stay during index hospitalization was 17.9 days (SD=23.78), with mean total cost of $157,274 (SD=$323,728). While the one-year pre-index mean total cost was $18,823 (SD=$38,506), the first year post-index mean total cost was $184,805 (SD=$349,355), and 92.7% were burn-related. On average, index hospitalization accounted for 85.1% of the first year cost. The second year mean total cost was $16,872 (SD=$47,423), with 17.9% burn-related. During the first year post-index, 23.2% of patients had ≥1 hospitalization, with 64.0% burn-related. The proportion of patients having inpatient hospitalization during the second year dropped to 13.7%, and only 15.7% were burn-related. The economic burden of thermal burn patients who were treated with inpatient autograft was significant in the first year after burn injuries. The major cost-driver during the first two years was the initial hospitalization with autograft. The proportion of burn-related utilization and cost considerably reduced in the second year post-index.