A cost analysis of diabetic lower-extremity ulcers.

Abstract

OBJECTIVE -Our objectives were to 1) estimate the prevalence of diabetes and diabetic lower-extremity ulcers in the Medicare population, 2) characterize Medicare population-specific costs for lower-extremity ulcer episodes, and 3) evaluate potential cost savings associated with better healing of lower-extremity ulcers.RESEARCH DESIGN AND METHODS -Prevalence and costs of diabetic lowerextremity ulcers were obtained by an analysis of Medicare claims data from 1995 and 1996 Standard Analytic Files (5% sample).RESULTS -Medicare expenditures for lower-extremity ulcer patients were on average 3 times higher than those for Medicare patients in general ($15,309 vs. $5,226). Lower-extremity ulcer-related spending accounted for 24% of total spending for lower-extremity ulcer patients. Most of the ulcer-related costs accrued on the inpatient side (73.7%); proportionately smaller amounts went to physicians and nursing home facilities. To determine the potential effect of better diabetic ulcer management, a model was created that estimated the impact on costs with improved healing rates. Improving the 20-week healing rate from 31 to 40% would save Medicare $189 per episode.CONCLUSIONS -Lower-extremity ulcers cost the Medicare system $1.5 billion in 1995. Any wound care intervention that could prevent even a small percentage of wounds from progressing to the stage at which inpatient care is required may have a favorable cost effect on the Medicare system.

Pé diabético: estratégias para prevenção

“…O gasto com as úlceras na fase prodrômica aumenta de 1,5 a 2,4 vezes, se comparado ao dispendido com pessoas sem úlceras, e, quando o problema se instala, este custo eleva-se a 5,4 vezes (15) , duplicando o índice de mortalidade dessas pessoas (16) . As hospitalizações causadas por pé diabético geralmente são prolongadas e recorrentes, exigindo grande número de consultas ambulatoriais e necessidade de cuidado domiciliar (15,17) . O processo de cicatrização das lesões ocorre de seis a 14 semanas, requerendo um perío-do de hospitalização de 30-40 dias, em países desenvolvidos, enquanto, no Brasil, essa média fica em torno de 90 dias (1) .…”

Personal and treatment factors associated with foot self-care among veterans with diabetes

“…Diabetes-related foot ulcers and amputations lead to increased risk of hospitalization, infection, amputation, lowered quality of life, and mortality as well as high medical and societal costs [2][3][4][5][6]. Risk factors for lower-limb complications include loss of sensation, peripheral arterial disease, and anatomic deformities [7][8].…”

Association Between Renal Failure and Foot Ulcer or Lower-Extremity Amputation in Patients With Diabetes

“…The health care costs associated with DFUs and LEAs are high. In 1995, U.S. Medicare claims for DFUs exceeded $1.4 billion (2). LEAs also have a profound effect on quality of life and are associated with increased health care costs and an increased risk of mortality (3)(4)(5).…”