Economic Aspect of the Diabetic Foot Syndrome
Čechurová D.1, Lacigová S.1, Rušavý Z.1, Horáková N.2, Jankovec Z.1, Žourek M.1
1I. interní klinika Lékařské fakulty UK a FN, Plzeň, přednosta prof. MUDr. K. Opatrný, jun., CSc. 2Lékařská fakulta UK, Plzeň, děkan doc. MUDr. B. Kreuzberg, CSc. |
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Summary:
The diabetic foot is one of the most expensive complications of diabetes mellitus. Aims: To determine
the direct costs of both inpatient and outpatient care of diabetic foot provided in Diabetic
Centre University Hospital in Plzeň. Methods: 42 patients with diabetic ulcers (45 % neuropathic,
26 % ischaemic and 29 % mixed) who have attended the podiatric surgery from January to June
2000 were randomly selected. Subject characteristics: 4 patients with type 1 diabetes, 38 patients
with type 2 diabetes, mean of age 63 years (37 - 81), mean of duration of diabetes 17 years (1 - 31),
mean of duration of diabetic ulcers 37 months (1 - 168) ulcers. Patients visited Diabetic Centre
9times (5 - 13). 23 hospitalisations occurred in 17 patients (40 %) with mean of 14 days duration (3 -
42). The AP-DRG (all patients diagnosis related groups) model was used to determine the hospital
direct costs. The ambulatory costs included the reimbursed care, drugs (local treatment, antibiotics
and antiagregans), bandages, patient transport and home care. Antidiabetic drugs and insulin
or antihypertensive drugs were not included. Results: Total direct costs of diabetic foot care 42
patients were 1 440.600.- CK, 34.500.- CK (6.300.- CK - 190.200.- CK)/patient in Diabetic Centre Plzeň
during 6 months. 37 % of total costs (533.000.- CK), resp. 12.500.- CK (5.900.- CK - 45.700.- CK)/patient
represented ambulatory and 63 % of total cost (907 600.- CK), resp. 53.700.- CK (18.000.- CK -
180.600.- CK)/patient hospital care.
Key words:
Economics - Diabetic foot - Diabetes mellitus - Cost of illness
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