The cost of a major paediatric burn.

There is little written on the financial cost of burns care. This project examined three major paediatric burns of 30-40% total body surface area (%TBSA) admitted to the South West Paediatric Burns Service in Bristol, and calculated the cost per patient of acute inpatient treatment. A list of costs was established for theatre time, bed time, medications and fluids, dressings, invasive procedures, therapy services and investigations. The time period was the initial inpatient stay, from admission to the burns service, to first discharge. Staff in the relevant managerial and purchasing departments provided additional information about charging. We calculated a mean cost per patient of £63,157.22 (range £55,354.79-£74,494.24). Our results suggest that current income achieved for a major paediatric burn underestimates the actual financial burden of treatment. The North Bristol NHS Trust tariff cost for a "major burn, third degree of more than 19% TBSA, or affecting multiple body regions with significant graft" is £17,797 (2009). The fact that our costs are almost certainly an underestimate in themselves serves to reinforce this view. We hope that the data presented here can provide some guidance and understanding in the funding of burns care, a complex and difficult area to cost.