Review The cost of prevention and treatment of pressure ulcers: A systematic review Liesbet Demarre´ a,b, *, Aure´ lie Van Lancker a , Ann Van Hecke a,c , Sofie Verhaeghe a , Maria Grypdonck a , Juul Lemey d , Lieven Annemans e , Dimitri Beeckman a,f,d a University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium b AZ Sint-Elisabeth Hospital, Zottegem, Belgium c Ghent University Hospital, Ghent, Belgium d Department of Bachelor in Nursing, Artevelde University College Ghent, Ghent, Belgium e Health Economics, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Brussels University, ICHER (Interuniversity Center for Health Economics Research), Belgium f Florence Nightingale School of Nursing & Midwifery, King’s College London, London, UK International Journal of Nursing Studies 52 (2015) 1754–1774 A R T I C L E I N F O Article history: Received 3 June 2014 Received in revised form 12 June 2015 Accepted 16 June 2015 Keywords: Costs and cost analysis Pressure ulcers Prevention Systematic review Treatment A B S T R A C T Introduction: Pressure ulcers impose a substantial financial burden. The need for high- quality health care while expenditures are constrained entails the interest to calculate the cost of preventing and treating pressure ulcers and their impact on patients, healthcare, and society. Objectives: The aim of this paper is to provide insight into the cost of pressure ulcer prevention and treatment in an adult population. Methods: A systematic literature review was performed to conform the Cochrane Collaboration guidelines for systematic reviews. The search strategy contained index terms and key words related to pressure ulcers and cost. The search was performed in Medline, CINAHL, Web of Science, The Cochrane Library, Embase, and EconLit covering articles up to September 2013. Reference lists and conference abstracts were screened. Articles were eligible if they reported on direct medical cost of pressure ulcer prevention or treatment, and provided national cost estimates, cost per patient, or cost per patient per day. The Consensus on Health Economic Criteria checklist was used to assess methodological quality of the included studies. Results: In total, 2542 records were retrieved. After assessing eligibility, 17 articles were included. Five articles reported on both the cost of prevention and treatment, three articles reported on cost of prevention, and nine articles reported on the cost of pressure ulcer treatment. All articles were published between 2001 and 2013. Cost of pressure ulcer prevention per patient per day varied between 2.65 s to 87.57 s across all settings. Cost of pressure ulcer treatment per patient per day ranged from 1.71 s to 470.49 s across different settings. The methodological heterogeneity among studies was considerable, and encompassed differences regarding type of health economic design, perspective, cost components, and health outcomes. * Corresponding author at: University Centre for Nursing and Midwifery, Ghent University, Block A, De Pintelaan 185, 9000 Gent, Belgium. Tel.: +32 9 332 33 14. E-mail address: Liesbet.demarre@gmail.com (L. Demarre´). Contents lists available at ScienceDirect International Journal of Nursing Studies journal homepage: www.elsevier.com/ijns http://dx.doi.org/10.1016/j.ijnurstu.2015.06.006 0020-7489/ß 2015 Elsevier Ltd. All rights reserved.