Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged

• Published in: Journal of tissue viability Vol. 26; no. 1; pp. 6 - 19
• Main Authors: Lichterfeld-Kottner, Andrea, Hahnel, Elisabeth, Blume-Peytavi, Ulrike, Kottner, Jan
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2017
• Subjects: Advanced Basic Science; Age Factors; Aged; Beds; Cost of Illness; Cost-Benefit Analysis; Critical Care; Dermatitis, Irritant - economics; Dermatitis, Irritant - prevention & control; Dermatitis, Irritant - therapy; Economic analyses; Humans; Incontinence associated dermatitis; Longitudinal Studies; Non-Randomized Controlled Trials as Topic; Observational Studies as Topic; Pressure Ulcer - economics; Pressure Ulcer - prevention & control; Pressure Ulcer - therapy; Pressure ulcers; Randomized Controlled Trials as Topic; Risk Factors; Skin - injuries; Skin Care - economics; Skin Care - instrumentation; Skin Care - methods; Skin tears; Aged; Pressure ulcers; Incontinence associated dermatitis; Economic analyses; Skin tears
• ISSN: 0965-206X
• DOI: 10.1016/j.jtv.2016.07.002

Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years). A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used. Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed. Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was identified. Because of the overall low methodological quality clear cut conclusions cannot be drawn. Robust and large scales economic evaluations about skin conditions and disease in aged populations are needed in the future. •35 publications reporting 38 economic analyses were included in this systematic review.•Most data were reported for skin tears, PU, and IAD.•Substantial heterogeneity in study and economic evaluation design was identified.•Standardized skin care indicated preventive effects, cost savings were diverse.•Limited evidence showed cost effectiveness for low air loss beds for PU prevention.