Model-Based Financial Consequences of Electrical Stimulation Therapy for Pressure Injury Healing

Background: Electrical stimulation (ES) is recommended as an adjunctive therapy for pressure injuries (PIs), but adoption requires implementation-relevant estimates of facility-level budget impact, including delivery costs. Methods: We conducted a model-based financial consequence analysis (provider perspective, Japan) using a 14-day randomized double-blind crossover trial (n = 12). Baseline time to heal under placebo (Tₚlacebo) was imputed from published median healing times stratified by DESIGN-R category and PI depth. A ratio-based healing acceleration parameter (r; treated as a secondary translation parameter) was used to estimate time to heal under ES (TES = Tₚlacebo/r) and days saved. Days saved were valued as a modeled gross offset using JPY 4000/day as a healing-related monetary value proxy; ES implementation costs comprised device allocation, consumables, and incremental staff time; and uncertainty was propagated via 10, 000 patient-level bootstrap resamples. Results: The primary crossover effect was Δ = 0. 128 cm2/day (ES minus placebo; p = 0. 008), and r was 3. 52 (95% uncertainty interval UI 1. 53–13. 67). Under the base-case modeled translation, mean Tₚlacebo was 177. 3 days and mean TES was 50. 4 days, yielding 126. 9 days saved (95% UI 63. 5–164. 9). The modeled gross offset (proxy-based) was JPY 507, 723/case (95% UI 253, 854–659, 434). Mean implementation cost was JPY 47, 794/case, giving a net financial impact (proxy-based) of JPY 459, 929/case (95% UI 158, 459–640, 086). Conclusions: Under the base-case-modeled assumptions, ES may be cost offsetting when healing-related care is valued using a monetary value proxy. However, prospective studies directly measuring time to heal and resource use are warranted.