The impact of comorbidities on inpatient Charcot neuroarthropathy cost and utilization

Labovitz, Jonathan M.; Shofler, David; Ragothaman, Kevin

doi:10.1016/j.jdiacomp.2016.01.004

Cited by 18 publications

(7 citation statements)

References 29 publications

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“…Therefore, patients received more treatments resulting in more costs, including supporting examinations, medical treatment, and hospitalisation. Overall, the services provided increased the total actual cost received by patients (Labovitz et al, 2016). Regarding LOS, the values of p = 0.0001 and r = 0.352 indicate a significant relationship between the secondary diagnose and the actual cost and a weak correlation.…”

Section: Factors Affecting the Actual Costmentioning

confidence: 89%

The comparison of the actual cost to case-mix of type 2 diabetes mellitus inpatient in Pandan Arang Boyolali hospital

2021

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Aim: The objective of this study was to determine the conformity of diabetes mellitus (DM) actual cost with the rate of Indonesia Case-Based Groups (INA-CBGs) among Universal Health Coverage (Jaminan Kesehatan Nasional - JKN) and non-JKN patients diagnosed with DM. Methods: This retrospective cross-sectional study was observational and analytic. It recruited DM inpatients with or without JKN. The data were analysed to identify the total actual cost of DM management among inpatients. Results: The results showed that the average cost for treating inpatient with diabetes mellitus at classes 1, 2, and 3 was IDR 2,677,003±906,406, IDR 2,881,023±851,483, and IDR 2,323,768±802,828, respectively. A positive difference of 378,509,126 was found between the actual cost and the INA-CBGs rate in 101 patients. There was a discrepancy between the real cost and the INA-CBGs rate for all treatment classes and the treatment levels. Factors influencing the real cost of treatment for DM were the length of stay and the severity level.

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Section: Factors Affecting the Actual Costmentioning

confidence: 89%

The comparison of the actual cost to case-mix of type 2 diabetes mellitus inpatient in Pandan Arang Boyolali hospital

2021

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“…Independientemente de estos factores, hay que señalar que en múltiples ocasiones no existe un diagnóstico correcto de esta patología en sus estadios iniciales, por lo que muchos pacientes sufren un retraso en la aplicación de un tratamiento eficaz que frene la evolución de la deformidad 2,3 . Esto viene motivado por la dificultad existente en realizar un diagnóstico certero en un estadio inicial de la patología (denominado estadio 0) que frecuentemente es confundido con otros procesos inflamatorios como celulitis, gota, trombosis venosa profunda o un simple esguince de tobillo ante la ausencia de deformidades clínicas o radiológicas 20,21 .…”

Section: Discussionunclassified

“…El pie de Charcot es una complicación de la diabetes mellitus (DM), que consiste en un proceso degenerativo severo de la estructura osteoarticular del pie que tiene secuelas significativas como movilidad limitada, ulceración, infección, amputación, disminución de la calidad de vida y aumento de la mortalidad global 1,2 . Se estima que entre el 0.1 y el 0.4 % de los pacientes diabéticos desarrollan esta patología que afecta principalmente al mediopié 3 .…”

Section: Introductionunclassified

Reconstrucción quirúrgica de un caso clínico complejo de neuroartropatía de Charcot

Pérez¹,

Cicchinelli²,

Huerta³

et al. 2020

Rev. Esp. Pod.

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La neuroartropatía de Charcot es reconocida como una enfermedad destructiva, progresiva y no infecciosa de origen multifactorial en pacientes con diabetes mellitus como principal causa etiológica. Esta destrucción puede ser a diferentes niveles del pie. El presente artículo presenta un caso clínico de un paciente que sufre una deformidad severa rígida en pie varo secundario a neuroartropatía de Charcot tipo II (según clasificación Sanders & Frykberg) en fase 2 (según clasificación de Eichenholtz) cuya solución de tratamiento propuesto era amputación infracondílea. Se realizó una reconstrucción quirúrgica de la deformidad consistente en alargamiento percutáneo del tendón de Aquiles, tenotomía del tibial posterior, fusión de la columna interna y externa con estabilización mediante placas de bloqueo; también se realizó fusión de la articulación subastragalina y trasposición del extensor común de los dedos y tibial anterior a la base del cuarto metatarsiano. El resultado del caso fue muy bueno y la evolución al año permitió al paciente incorporarse a su actividad diaria. Este artículo pretende mostrar una opción de tratamiento para este tipo de patología con buenos resultados y mostrando una posibilidad de solución a estos pacientes, evitando así la amputación del miembro.

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“…In 2018, a regional survey of 205,033 people with diabetes in the East Midlands, UK, reported a point prevalence of 0.04% [4]. CN is associated with increased length of stay and use of medical resources [5].…”

Section: Introductionmentioning

confidence: 99%

A randomised feasibility study of serial magnetic resonance imaging to reduce treatment times in Charcot neuroarthropathy in people with diabetes (CADOM): a protocol

Gooday

Game

Woodburn

et al. 2020

Pilot Feasibility Stud

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Background: Charcot neuroarthropathy is a complication of peripheral neuropathy associated with diabetes which most frequently affects the lower limb. It can cause fractures and dislocations within the foot, which may progress to deformity and ulceration. Recommended treatment is immobilisation and offloading, with a below knee nonremovable cast or boot. Duration of treatment varies from six months to more than 1 year. Small observational studies suggest that repeated assessment with magnetic resonance imaging improves decision-making about when to stop treatment, but this has not been tested in clinical trials. This study aims to explore the feasibility of using serial magnetic resonance imaging without contrast in the monitoring of Charcot neuroarthropathy to reduce duration of immobilisation of the foot. A nested qualitative study aims to explore participants' lived experience of Charcot neuroarthropathy and of taking part in the feasibility study. Methods: We will undertake a two-arm, open study and randomise 60 people with a suspected or confirmed diagnosis of Charcot neuroarthropathy from five NHS, secondary care multidisciplinary Diabetic Foot Clinics across England. Participants will be randomised 1:1 to receive magnetic resonance imaging at baseline and remission up to 12 months, with repeated foot temperature measurements and X-rays (standard care plus), or standard care plus with additional three-monthly magnetic resonance imaging until remission up to 12 months (intervention). Time to confirmed remission of Charcot neuroarthropathy with off-loading treatment (days) and its variance will be used to inform sample size in a full-scale trial. We will look for opportunities to improve the protocols for monitoring techniques and the clinical, patient-centred and health economic measures used in a future study. For the nested qualitative study, we will invite a purposive sample of 10-14 people able to offer maximally varying experiences from the feasibility study to take part in semi-structured interviews to be analysed using thematic analysis.

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The impact of comorbidities on inpatient Charcot neuroarthropathy cost and utilization

Cited by 18 publications

References 29 publications

The comparison of the actual cost to case-mix of type 2 diabetes mellitus inpatient in Pandan Arang Boyolali hospital

The comparison of the actual cost to case-mix of type 2 diabetes mellitus inpatient in Pandan Arang Boyolali hospital

Reconstrucción quirúrgica de un caso clínico complejo de neuroartropatía de Charcot

A randomised feasibility study of serial magnetic resonance imaging to reduce treatment times in Charcot neuroarthropathy in people with diabetes (CADOM): a protocol

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