Abstract
Background Little is known about the economic impact of diabetic foot ulceration in the Irish healthcare setting.
Aim Audit of diabetic foot ulcer admissions in St James’s Hospital between April 2001 and March 2002.
Methods Hospital charts were reviewed and costs were calculated on the length of patients’ hospital stay and the cost of individual investigations performed.
Results Thirty patients were admitted with diabetic foot ulceration as the primary complaint. Amputation was performed in eight patients, two patients with a non-healing ulcer died. The average duration of each hospital admission was 20.3±30.7 days. Net in-hospital expenditure was ∈704,689, an average of ∈23,489.63 per hospital admission.
Conclusions The management of diabetic foot ulceration has a significant economic impact on the Irish healthcare budget. Treatment should therefore be focused on primary prevention through specialised foot clinics and a multidisciplinary team approach to reduce this economic burden.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Walters DP, Gatling W, Mullee MA, Hill RD. The distribution and severity of diabetic foot disease: a community based study with comparison to a non-diabetic group.Diabetic Medicine 1992; 9: 354- 8.
Reiber GE, Lipsky BA, Gibbons GW. The burden of diabetic foot ulcers.Am J Surg 1998; 176: 5S-10S.
Jeffcoate WJ, Harding KG. Diabetic foot ulcers.The Lancet 2003; 361: 1545- 51.
Apelqvist J, Agardh CD. The association between clinical risk factors and outcome of diabetic foot ulcers.Diabetes Res Clin Prac 1992; 18: 43- 45.
Lithner FG. The diabetic foot: epidemiology and economic impact.IDF Bulletin 1992; 38: 7–9.
Reiber GE. Diabetic foot care. Financial implications and practice guidelines.Diabetes Care 1992; 15 Suppl (1): 29–31.
Jonsson B. Diabetes: the cost of illness and the cost of control. An estimate for Sweden 1978.Acta Med Scand 1983; 671: 19–27.
VanAcker K, Oleen-Buckley M, DeDecker L et al. Cost and resource utilization for prevention and treatment of foot lesions in a diabetic foot clinic in Belgium.Diabetes Res Clin Pract 2000; 50: 87–95.
Tennvall GR, Apelqvist J, Eneroth M. Costs of deep foot infections in patients with diabetes mellitus.Pharmacoeconomics 2000; 18: 225–38.
Harding K, Cutting K, Price P. The cost-effectiveness of wound management protocols of care.Brit J Nurs 2000; 19: S6-S24.
Reiber GE, Vileikyte L, Boyko EJ et al. Causal pathways for incident lower- extremity ulcers in patients with diabetes from two settings.Diabetes Care 1999; 22: 157–62.
Macfarlane RM, Jeffcoate WJ. Factors contributing to the presentation of diabetic foot ulcers.Diabetic Medicine 1997; 14: 867–70.
Delamaire M, Maugendre D, Moreno M et al. Impaired leucocyte function in diabetic patients.Diabetic Medicine 1997; 14: 29–34.
Adler EI, Boyko EJ, Ahroni JH et al. Lower- extremity amputation in diabetes: the independent effects of peripheral vascular disease, sensory n e u ropathy and foot ulcers.Diabetes Care 1999; 22: 1029–35.
Apelqvist J, Larsson J, Agardh C-D. Long term prognosis for diabetic patients with foot ulcers.J Intern Med 1993; 233: 485–91.
Ragnarsson T, Tennvall G, Apelqvist J. Prevention of diabetes-related foot ulcers and amputations: a cost utility analysis based on Markov model simulations.Diabetologia 2001; 44: 2077–81.
Horswell RL, Birke JA, Patout CA Jr. A staged management diabetes foot program versus standard care: a 1-year cost and utilization comparison in a state public hospital system.Arch Phys Med Rehab 2003; 84: 1743–46.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Smith, D., Cullen, M. & Nolan, J. The cost of managing diabetic foot ulceration in an Irish hospital. Ir J Med Sci 173, 89–92 (2004). https://doi.org/10.1007/BF02914564
Issue Date:
DOI: https://doi.org/10.1007/BF02914564