Comparison home care service versus hospital-based care in patients with diabetic foot ulcer: an economic evaluation study

Jafary,; Amini, Mohammad Reza; Sanjari, Mahnaz; Aalaa, Maryam; Goudarzi, Zahra; Najafpour, Zhila; Tehrani, M R Mohajeri

doi:10.1007/s40200-020-00527-y

Cited by 18 publications

(25 citation statements)

References 19 publications

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“…Out the 14 studies, eight were conducted in the UK [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ], three in the Netherlands [ 24 , 25 , 26 ], one from Sweden [ 27 ], one from Italy [ 28 ] and one from Iran [ 29 ]. The studies were mainly published before 2010.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies included home visits by specialist team [ 17 , 20 , 21 , 22 , 23 , 28 , 29 ], three studies included home visits by nurses (nursing care) [ 18 , 24 , 27 ] and three studies included visit by other specialists [ 16 , 19 , 26 ]. Additional intervention components included telemonitoring and nursing care [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most of the included studies (n = 11) [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] received financial support from public healthcare or non-profit organizations. Two studies did not report funding sources [ 27 , 29 ] and one declared “no funding sources” [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies performed a cost-effectiveness analysis [ 17 , 18 , 19 , 23 , 24 , 25 , 27 , 29 ] and six performed cost-minimization analyses [ 16 , 20 , 21 , 22 , 26 , 28 ]. The cost components were organized into three categories: direct medical, indirect and non-medical costs.…”

Section: Resultsmentioning

confidence: 99%

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The Cost-Effectiveness of Homecare Services for Adults and Older Adults: A Systematic Review

Curioni

Silva

Damião

et al. 2023

IJERPH

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This study provides an overview of the literature on the cost-effectiveness of homecare services compared to in-hospital care for adults and older adults. A systematic review was performed using Medline, Embase, Scopus, Web of Science, CINAHL and CENTRAL databases from inception to April 2022. The inclusion criteria were as follows: (i) (older) adults; (ii) homecare as an intervention; (iii) hospital care as a comparison; (iv) a full economic evaluation examining both costs and consequences; and (v) economic evaluations arising from randomized controlled trials (RCTs). Two independent reviewers selected the studies, extracted data and assessed study quality. Of the 14 studies identified, homecare, when compared to hospital care, was cost-saving in seven studies, cost-effective in two and more effective in one. The evidence suggests that homecare interventions are likely to be cost-saving and as effective as hospital. However, the included studies differ regarding the methods used, the types of costs and the patient populations of interest. In addition, methodological limitations were identified in some studies. Definitive conclusions are limited and highlight the need for better standardization of economic evaluations in this area. Further economic evaluations arising from well-designed RCTs would allow healthcare decision-makers to feel more confident in considering homecare interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The Cost-Effectiveness of Homecare Services for Adults and Older Adults: A Systematic Review

Curioni

Silva

Damião

et al. 2023

IJERPH

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“…They noted that by discharging patients with DFU home and setting them up with home care nursing in a Hospital-In-A-Home program, both saved money and led to faster wound healing when compared to those who were hospitalized. 24 Their study did not assess the rate of readmissions.…”

Section: Discussionmentioning

confidence: 99%

Laboratory and Pharmaceutical Data Associated With Hospital Readmission in Persons With Diabetic Foot Ulcers

Myers

Dawkins

Baskaran

et al. 2021

INQUIRY

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Purpose: Diabetic foot ulcers (DFUs) are a leading cause of lower extremity amputations among persons with diabetes (PWD) and a common cause of hospitalizations. This study identified demographic characteristics, lab values, and comorbidities associated with 30-day and 90-day hospital readmission in persons with DFU. Methods: A retrospective chart review at our institution examined 397 patients with type 2 diabetes admitted with DFU between January 2014 and December 2018. Variables were analyzed using descriptive statistics, t-tests, and logistic regressions. Results: None of the studied demographic, laboratory (including Hemoglobin A1c) or comorbid diseases were associated with 30-day readmission in persons with DFU. Risk factors for 90-day readmission included discharge location to home with health care (OR: 2.62, 95% CI: 1.39, 4.95), anticoagulant use (OR: 2.36, 95% CI: 1.27, 4.39), and SQ insulin use (OR: 2.08, 95% CI: 1.20, 3.61). Conclusions: None of the variables examined were associated with 30-day readmission; however, potential predictors for 90-day readmission included anticoagulation or insulin use and discharge home with healthcare services. Future studies should devise interventions to improve transition of care in patients with DFU to further assess the role of medications and home health care as a potential predictor of 90-day hospital readmission.

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Cost‐effectiveness of temperature monitoring to help prevent foot ulcer recurrence in people with diabetes: A multicenter randomized controlled trial

Van Netten,

Aan De Stegge,

Dijkgraaf

et al. 2024

Diabetes Metabolism Res

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AimsDiabetes‐related foot ulcers are common, costly, and frequently recur. Multiple interventions help prevent these ulcers. However, none of these have been prospectively investigated for cost‐effectiveness. Our aim was to evaluate the cost‐effectiveness of at‐home skin temperature monitoring to help prevent diabetes‐related foot ulcer recurrence.Materials and MethodsMulticenter randomized controlled trial. We randomized 304 persons at high diabetes‐related foot ulcer risk to either usual foot care plus daily at‐home foot skin temperature monitoring (intervention) or usual care alone (control). Primary outcome was cost‐effectiveness based on foot care costs and quality‐adjusted life years (QALY) during 18 months follow‐up. Foot care costs included costs for ulcer prevention (e.g., footwear, podiatry) and for ulcer treatment when required (e.g., consultation, hospitalisation, amputation). Incremental cost‐effectiveness ratios were calculated for intervention versus usual care using probabilistic sensitivity analysis for willingness‐to‐pay/accept levels up to €100,000.ResultsThe intervention had a 45% probability of being cost‐effective at a willingness‐to‐accept of €50,000 per QALY lost. This resulted from (non‐significantly) lower foot care costs in the intervention group (€6067 vs. €7376; p = 0.45) because of (significantly) fewer participants with ulcer recurrence(s) in 18 months (36% vs. 47%; p = 0.045); however, QALYs were (non‐significantly) lower in the intervention group (1.09 vs. 1.12; p = 0.35), especially in those without foot ulcer recurrence (1.09 vs. 1.17; p = 0.10).ConclusionsAt‐home skin temperature monitoring for diabetes‐related foot ulcer prevention compared with usual care is at best equally cost‐effective. The intervention resulted in cost‐savings due to preventing foot ulcer recurrence and related costs, but this came at the expense of QALY loss, potentially from self‐monitoring burdens.

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Comparison home care service versus hospital-based care in patients with diabetic foot ulcer: an economic evaluation study

Cited by 18 publications

References 19 publications

The Cost-Effectiveness of Homecare Services for Adults and Older Adults: A Systematic Review

The Cost-Effectiveness of Homecare Services for Adults and Older Adults: A Systematic Review

Laboratory and Pharmaceutical Data Associated With Hospital Readmission in Persons With Diabetic Foot Ulcers

Cost‐effectiveness of temperature monitoring to help prevent foot ulcer recurrence in people with diabetes: A multicenter randomized controlled trial

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