Cost analysis of a major burn.

A retrospective review was undertaken of 26 patients admitted to Middlemore Hospital between January 1986 to July 1989 with burns totalling more than 30% of total body surface area. An attempt was made to estimate the total cost of successful inpatient management of a major burn using known and assumed values. The new schedule of interboard hospital charges was also employed for greater accuracy. The 20 survivors had a mean initial hospital stay of 68.7 days at a cost of between $37,077 and $40,702 (1989 values) and $46,069 (1991 values). This latter figure equates to an average cost of $647 per patient per day or, alternatively, $927 per % burn. Suggestions to reduce costs and improve treatment include: earlier excision and grafting; the establishment of a regional skin bank and keratinocyte culture facility to aid wound closure; and guidelines on antibiotic prescribing.