National estimates of the economic burden of pressure injuries are large, consistent and widely quoted. The figure for the United Kingdom is £1.4–2.1 billion a year, roughly four per cent of NHS expenditure. For Ireland it’s around €250 million across all care settings and, for the United States, $26.8 billion, of which some 59% is associated with the most serious stage 3 and 4 ulcers.
These figures are shocking, but they don’t necessarily create a sense of urgency among the stakeholders upon whom hospital-wide pressure injury prevention depends. For this reason an institution-level estimate is needed. Fortunately, the arithmetic required to calculate one is neither complicated nor contentious. You can do it for your hospital using this downloadable Excel worksheet and the short instructional video below.
Take a hypothetical 300-bed European general hospital admitting 15,000 patients a year. A hospital-acquired pressure-injury incidence of 4% (a conservative figure compared to reported European prevalence of 7–23%) leads to 600 injuries per year. Assigning 10% of these to categories 3–4, and applying four and ten excess bed days respectively, produces 2,760 excess bed days. At €600 per bed day that’s an annual cost of €1.66 million.
But the financial impact is only the tip of the iceberg. When you divide 2,760 excess bed days by 365 you see immediately that they represent 7.6 beds occupied continuously throughout the year, approximating a single eight-bed ward entirely dedicated to treating pressure injuries acquired during a hospital stay. If a typical inpatient admission is for 6 days this corresponds to 445 admissions that cannot happen because beds are blocked by patients with hospital-acquired pressure injuries. So in publicly funded systems the saving from pressure ulcer prevention is largely capacity-releasing rather than cash-releasing: no budget line falls, but significant bed capacity is returned – and bed capacity is the most important constraint affecting hospitals today.
So how much does it cost to prevent pressure injuries in the first place? A bottom-up costing of €7.88 per at-risk patient per day (inclusive of nursing time but excluding equipment and consumables) comes to approximately €213,000 a year for the same institution. Applying the pooled risk ratio of 0.55 reported for prevention care bundles yields around €745,000 of avoided burden – a ratio of roughly three and a half to one.
This estimate has three limitations worth noting. Firstly, it values excess bed days only. Treatment costs are excluded entirely and scale far more steeply with category, so the burden is understated rather than inflated. Secondly, the effectiveness estimate comes from non-randomised studies graded very low for certainty and the randomised evidence at programme level is non-significant. Thirdly, the category-specific stratification of excess stay is an assumption rather than a published value. Interestingly, no peer-reviewed budget or resource impact analysis of a hospital-wide pressure injury prevention programme appears to have been published yet.
The value of this quick calculation is its transferability. Four of the five parameters are measurements that a typical hospital already has or can easily obtain from published sources. Only the bed-day cost requires a conversation with the finance department and having that conversation is itself a good reason for doing this calculation. Being able to state what pressure injuries cost your hospital in bed days over the last year is a first, necessary step in building a sense of urgency for a hospital-wide pressure injury prevention project.
This analysis was presented at the EPUAP – European Pressure Ulcer Advisory Panel annual meeting in Dublin on 10 September 2026, during a symposium sponsored by Mölnlycke Health Care. You are welcome to download the Powerpoint slide presentation delivered at the symposium. You may also like to download this Excel worksheet that you can use to build your own business case for a pressure injury prevention programme.
