Review Article

The Costs of Burn Victim Hospital Care around the World: A Systematic Review


Background: Burn injuries are very common and fire-related burns account for over 300,000 deaths per year globally. The costs of the treatment of these patients change around the world. The aim of the present study was to conduct a systematic literature review to identify the costs related to hospital stays of burn victims in countries with different Human Development Index (HDIs).

Methods: PubMed, CINAHL and BVIS databases were searched using the following terms: “burn,” treatment” and “costs”. The review included articles that presented cost studies or economic assessments of burn victims in which the costs were reported, and published between 2012 and 2019. The quality of the evidence was assessed using the Consensus on Health Economic Criteria. This review presents register in Prospero (CRD42019137580).

Results: The review included 19 economic studies conducted in 13 countries, most with a very high HDIs. Most studies estimated direct acute burn care costs through bottom-up costing and institutional data. Total hospital care costs ranged from US$ 10.58 to US$ 125,597.86 per patient, the cost of 1% of total body surface area burned ranged from US$ 2.65 to US$ 11,245.04, and the cost of hospital care per day, from US$ 24.23 to US$ 4,125.50.

Conclusion: The costs are high and show wide discrepancies among countries. Medical costs and other losses caused by fatal and non-fatal burn injuries differ considerably among demographic groups, care protocols, and country HDIs.

1. World Health Organization (2008). A WHO plan for burn prevention and care.
2. Smolle C, Cambiaso-Daniel J, Forbes AA, et al (2017). Recent trends in burn epidemi-ology worldwide: A systematic review. Burns, 43(2):249-257.
3. American Burn Association Burn Incidence Fact Sheet (2016). Burn incidence and treatment in the United States, 2016.
4. Hemington-Gorse SJ, Potokar TS, Drew PJ, et al (2009). Burn care costing: the Welsh experience. Burns, 35(3):378-82.
5. Hop MJ, Polinder S, Van Der Vlies CH, et al (2014). Costs of burn care: A systematic review. Wound Repair Regen, 22(4):436-50.
6. Evers S, Goosens M, deVet H, et al (2005). Criteria list for assessment of methodo-logical quality of economic evaluations: Consensus on Health Economic Criteria. Int J Technol Assess Health Care, 21(2):240-5.
7. United Nations Development Programme UNPD (2018). Human Development In-dices and Indicators 2018 Statistical up-date.
8. Brasil (2019). Banco Central do Brasil. Conversor de moedas.
9. Ahn CS, PK M (2012). The true cost of burn. Burns, 38(7): 967–974.
10. Seah R, Holland AJ, Curtis K, et al (2018). Hospitalized burns in children up to 16 yr old: A 10-year population-based study in Australia. J Paediatr Child Health, 55(9):1084-1090.
11. Hop MJ, Wijnen BF, Nieuwenhuis MK, et al (2016). Economic burden of burn injuries in the Netherlands: A 3 months follow-up study. Injury, 47(1):203-10.
12. Mushin OP, Esquenazi MD, Ayazi S, et al (2019). Self-inflicted burn injuries: Etiolo-gies, risk factors and impact on institu-tional resources. Burns, 45(1):213-219.
13. George S, Javed M, Hemington-Gorse S, et al (2016). Epidemiology and financial im-plications of self-inflicted burns. Burns, 42(1):196-201.
14. Jeevan R, Rashid A, Lymperopoulos NS, et al (2014). Mortality and treatment cost es-timates for 1075 consecutive patients treated by a regional adult burn service over a five year period: the Liverpool ex-perience. Burns, 40(2): 214-22.
15. Haikonen K, Lillsunde PM, Vuola J (2014). Inpatient costs of fire-related injuries in Finland. Burns, 40(8):1754-60.
16. Santos JV, Oliveira A, Costa-Pereira A, et al (2016). Burden of burns in Portugal, 2000-2013: A clinical and economic anal-ysis of 26,447 hospitalizations. Burns, 42(4):891-900.
17. Karimi H, Motevalian SA, Momeni M, et al (2015). Financial burden of burn injuries in Iran: a report from the burn registry program. Ann Burns Fire Disasters, 31;28(4):310-314.
18. Latifi NA, Karimi H, Motevalian SA, et al (2017). Economical Burden of Burn Inju-ries in a Developing Country. J Burn Care Res, 38(6): e900-e905.
19. Emami SA, Motevalian SA, Momeni M, et al (2016). The epidemiology of geriatric burns in Iran: A national burn registry-based study. Burns, 42(5):1128-1132.
20. Arslan K, Çiftçi I, Dogru O, et al (2013). The Necessity of Burn Treatment Units. EJIM, 10(1):39-46.
21. Eser T, Kavalci C, Aydogan C, et al (2016). Epidemiological and cost analysis of burn injuries admitted to the emergency department of a tertiary burn center. Springerplus, 5(1):1411.
22. Anami EHT, Zampar EF, Tanita MT, et al (2017). Treatment costs of burn victims in a university hospital. Burns, 43(2):350-356.
23. Santos JV, Souza J, Amarante J, et al (2017). Burden of bunrs in Brazil from 2000 to 2014: A nationwide hospital-based study. World J Surg, 41(8):2006-2012.
24. Ter Meulen EW, Poley MJ, Van Dijk M, et al (2016). The hospital costs associated with acute paediatric burn injuries. S Afr Med J, 2 106(11):1120-1124.
25. Ahuja RB, Goswami P (2013). Cost of providing inpatient burn care in a tertiary, teaching, hospital of North India. Burns, 39:558–64.
26. Gallaher JR, Mjuweni S, Cairns BA, et al (2015). Burn care delivery in a sub-saharan african unit: A cost analysis study. Int J Surg, 19:116-20.
27. Kao HK, Loh CYY, Kou HW, et al (2018). Optimizing mass casualty burns intensive care organization and treatment using ev-idence-based outcome predictors. Burns, 44(5):1077-1082.
28. World Health Organization (2018). Fact Sheets Burns 2018.
29. Brasil (2014). Ministério da Saúde. Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes Metodológicas Diretriz de avaliação econômica, 2ª Ed. Brasília: Ministério da Saúde. 2014.
30. Saavedra PAE, Brito ES, Areda CAA, et al (2019). Burns in the Brazilian Unified Sys-tem: a review of hospitalization from 2008 to 2017. Int J Burn Trauma, 9(5):88-98.
31. Ribeiro RA, Neyeloff JL, Itria A, et al (2016). Diretriz metodológica para estudos de avaliação econômica de tecnologias em saúde no Brasil. J Bras Econ Saúde, 8(3):174-184.
32. Gonçalves MA, Alemão MM (2018). Avaliação econômica em saúde e estudos de custos: uma proposta de alinhamento semantico de conceitos e metodologias. Rev Med Minas Gerais, 28(Supl 5):eS280524.
33. Koljonen V, Laitila M, Rissanen AM, et al (2013). Treatment of Patients With Severe Burns-Costs and Health-Related Quality of Life Outcome. J Burn Care Res, 34:e318–25.
34. Saavedra PAE, Soares LS, Nascimento SB, et al (2018). Do trigger tool drug adverse events apply to patients hospitalized for burns? Rev Bras Queimaduras, 17(1):20-7
35. Nascimento SB, Soares LSS, Areda CA, et al (2015). Profile of hospitalized patients in burn’s unit of a reference hospital in Bra-silia. Rev Bras Queimaduras, 14(3):211-7.
36. Bedri H, Romanoswski KS, Liao J, et al (2017). A national study of the effect of race, socioeconomic status, and gender on burn outcomes. J Burn Care Res, 38(3):161-168
37. Walker DG, Wilson RF, Sharma R, et al (2012). Best Practices for Conducting Economic Evaluations in Health Care: A Systematic Review of Quality Assessment Tools. Methods Research Report. (Pre-pared by Johns Hopkins University Evi-dence-based Practice Center under con-tract No. 290-2007-10061-I.) AHRQ Publication No. 12(13)-EHC132-EF. Rockville, MD: Agency for Healthcare Research and Quality. October 2012.
38. Florence C, Simon T, Haegerich T, et al (2015). Estimated lifetime medical and work-loss of fatal injuries--United States, 2013. MMWR Morb Mortal Wkly Rep, 64(38):1074-7.
IssueVol 50 No 5 (2021) QRcode
SectionReview Article(s)
Burn Injury Burn units Cost and costs analysis Health care costs

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How to Cite
Escalante Saavedra PA, Leal JV, Areda C, Galato D. The Costs of Burn Victim Hospital Care around the World: A Systematic Review. Iran J Public Health. 50(5):866-878.