In-hospital costs of diabetic foot disease treated by a multidisciplinary foot team

Abstract

Background The diabetic foot imposes significant burden on healthcare systems. Obtaining knowledge on the extent of the costs of diabetic foot ulcers (DFUs) is of value to health care researchers investigating cost-effectiveness of interventions that prevent these costly complications. Objectives To estimate the in-hospital costs associated with the treatment of DFUs by a multidisciplinary diabetic foot team. Methods Persons with DFUs presenting to our team in 2013 and 2014 were followed and use of care was estimated. Exclusion criteria were a single visit only and ulcers above the ankle. Demographic data and per-person incremental clinical outcomes (e.g., healing with or without amputation and rehabilitation) were assessed. Resource use was identified, measured and multiplied by unit costs. Results Eighty-nine persons were identified with 56 persons meeting the inclusion criteria (with 69 DFU episodes). The median in-hospital care was 17 weeks (inter quartile range: 7–34). Average in-hospital costs were US$ 10,827 (range: 702–82,880) per DFU episode. Primary healed DFUs costs on average US$ 4830, single minor amputations on average US$ 13,580, multiple minor amputations on average US$ 31,835 and major amputations on average US$ 73,813 per episode. Costs differed significantly between groups (p < 0.001). Conclusion DFUs are associated with substantial immediate and long-term in-hospital costs. Our study provides estimates of these costs, aiding researchers and health policy analysis.