<p>Cost of Diabetic Foot Ulcer Management in China: A 7-Year Single-Center Retrospective Review</p>

Abstract

Background The cost of care for diabetic foot ulcers has became a global economic burden. The study aimed to analyze diabetic foot ulcer cost changes over time and to identify factors associated with these variables, so as to strengthen and improve the management of diabetic foot ulcers. Methods We retrospectively analyzed the data in the electronic medical record system of our wound treatment center. The homepage of the system was queried using the national clinical version 2.0 disease diagnosis code (ICD-10), the data of patient’s basic information were exported. Through the statistics and analysis of these data, the socioeconomic changes and possible risk factors of diabetic foot ulcers management in recent years were obtained. Results There were 3654 patients included in the study, an average of 522 per year. The total cost per patient increased from ¥15,535.58 in 2014 to ¥42,040.60 in 2020, with an average of ¥21,826.91. The average length of stay between 14.29 days and 31.4 days from 2014 to 2020, with an average of 18.10 days. Besides, the average incidence of peripheral arterial disease in diabetic foot ulcers patients admitted was as high as 81.9%, and the average amputation rate was 9.9%. The study reflected the total cost and length of stay of diabetic foot patients increased significantly from 2014 to 2020, which were related to age (>85 years), gender (male), peripheral arterial disease, amputation (P < 0.05). Conclusion A heavy cost from diabetic foot ulcers and its complications was significantly increased yearly, which was related to older age, co-morbidity, amputation and duration of hospitalization. The prevention and treatment of diabetic foot ulcers have a long way to go, early comprehensive prevention and multi-disciplinary cooperation may still be an effective way.

Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients

“… 3 Among complications, it is generally known that diabetic foot ulcer (DFU) is the most frequently recognized complication, which is a kind of disease related to neuropathy and/or peripheral arterial disorder of the lower extremities and with infection, ulceration, and destruc tion of deep tissues in diabetic patients, as a result of the interaction of factors induced by sustained and uncontrolled hyperglycemia. 4 DFU is a rising health problem due to increasing prevalence of diabetes worldwide, and treatment of these foot ulcers is challenging because of their multifactorial aetiology, and it places a high burden on patients, healthcare systems and society. 5 It is estimated that 15–25% of people with diabetes will be affected by a foot ulcer at some point in their lives.…”

“…The annual incidence and 7-year average incidence of amputation for DFU patients were 5.1 and 9.9% respectively in China. 4 , 13 Surprisingly, amputation rate as high as 52% was reported among patients hospitalized for DFU in one tertiary healthcare center in Nigeria. 14 Efforts to prevent this unpleasant situation therefore deserve utmost attention, and this could be partly accomplished by risk factor identification.…”

Comparative Analysis of Actual Cost and INA CBG Rate in Diabetic Gangrene Inpatients

“…The average total cost of care has been increasing until 2020 as it is recorded that the average total cost is ¥42,040.60. The total cost of treatment and length of treatment increases in relation to amputation (P < 0.05) (Lu et al, 2020). In some cases of diabetic gangrene, amputation is performed.…”

The Effect of Electroacupuncture Preconditioning on Regional Cerebral Oxygen Saturation Levels in Elderly Patients with Diabetes

“… 6 The 7-year average incidence of amputation in patients with moderate diabetic foot ulcers was 9.9%. 7 Additionally, amputation was indicated as being associated with an increase in overall cognitive impairment and the impairment of episodic memory in elderly patients with diabetic foot. 8 …”