Cost of lower-limb amputation in U.S. veterans with diabetes using health services data in fiscal years 2004 and 2010

Abstract

Abstract-The purpose of this study was to estimate healthcare costs associated with diabetes-related lower-limb amputations (LLAs) within the Veterans Health Administration (VHA). We performed a cross-sectional comparative analysis of 3,381 VHA clinic users in fiscal year (FY) 2004 and 3,403 VHA clinic users in FY2010 identified as having type 2 diabetes mellitus and nontraumatic LLA. LLA expenditures related to inpatient medical, inpatient surgical, and outpatient care were estimated using VHA Health Economics Resource Center average cost files. LLA-related pharmaceutical costs were obtained from VHA Decision Support Systems national extract files. From the Department of Veterans Affairs (VA) perspective, the mean cost associated with care for diabetes-related LLA per patient in the VA healthcare system in FY2004 was $50,351 (95% confidence interval [CI] = 48,939-51,803) in 2012 U.S. dollars; the total cost for all 3,381 patients was $170,236,037. In FY2010, cost per patient rose to $60,647 (95% CI = 59,188), with a total cost of $206,380,331 for 3,403 patients. In the VHA healthcare system, the economic burden associated with LLAs in patients with diabetes exceeded $200,000,000 in FY2010. This suggests that further improvements in care of patients with diabetes could be associated with significant cost savings.

Human Wounds and Its Burden: An Updated Compendium of Estimates

“…The economic burden of lower limb amputations in diabetic veterans was $206 million. 151 The Combat Casualty Care Research Program is a collaborative, multidisciplinary partnership that utilizes clinical and translational research to provide state-of-the-art wound care. 152 With an effort to maximize restoration of function and QoL in service members with combat-related extremity trauma, the VA and DoD have increased their research and clinical care efforts with a focus on regenerative medicine.…”

Matrix therapy is a cost-effective solution to reduce amputation risk and improve quality of life: pilot and case studies

“…Indeed, if we consider that 50% of patients with non-healing critical ischemia chronic ulcers require amputation, treatment with OTR4120 could lead to massive savings for the health care system since none of the patients in this report required amputation in follow-up. Each year about 150,000 lower extremity amputations secondary to peripheral vascular disease (PVD) or diabetes are performed in the US alone, with a cost of about 60,000 dollars (in 2010) per patient, not including follow-up care [8,9].…”

Regional variation in the risk of lower‐limb amputation among patients with diabetes in New Zealand

“…Lower‐limb amputation is one of the most substantial and debilitating consequences of diabetes mellitus. Lower‐limb amputation has substantial impact on both the patient and health care services; although there is an absence of recent cost data from New Zealand (NZ), the direct cost of lower‐limb amputation in Australia is estimated to be nearly $30 000, while a recent US study estimated this cost to be US$50 000–$60 000 …”

“…Lower-limb amputation has substantial impact on both the patient and health care services; although there is an absence of recent cost data from New Zealand (NZ), the direct cost of lower-limb amputation in Australia is estimated to be nearly $30 000, 1 while a recent US study estimated this cost to be US$50 000-$60 000. 2 The risk of lower-limb amputation among patients with diabetes mellitus varies across several sociodemographic and clinical risk factors. Older patients are more likely to undergo amputation than younger patients, 3 and patients with substantial comorbidity in addition to their diabetes are at higher risk than those with little or no comorbidity.…”