Costs of ambulatory treatment of diabetic foot In the Multidisciplinary Diabetic Foot Clinic of Medical University in Gdańsk in 2007

Abstract

INTRODUCTION. Diabetic foot disease is a long term and costly complication of diabetes in many cases resulting in ulceration which significantly increases the risk of amputation. The aim of the study was to evaluate of ambulatory costs of treatment of diabetic foot patients in the specialized foot clinic and compare with reimburstment from the NHS system.
MATERIAL AND METHODS. 403 case histories of 161 female and 242 male patients (mean age 64.3 ± 11.6 mean diabetes duration 18 ± 10 years) were analysed with respect to etiology of the ulcer, Wagner stage, results and costs of treatment (costs of consultations and investigations, dressings as well as clinic maintenance costs).
RESULTS. During two analysed months of the year 2007, 638 consultations were performed in 403 patients. 50% of patients were seen for prevention (callus removal, nail cutting). 80% of ulcers were neuropathic and 12% neuroischemic. Ulcers were located in the midfoot 23%, 9.5% on the toes and 8% on the heel. According to Wagner scale 52% of the ulcers were stage 1.28% stage 2 and 12% stage 3. Mean HbA_1c was 8.5%. Total costs of Diabetic Foot Clinic were 19 007 PLN and reimburstment covered the expenses of the clinic.
CONCLUSIONS. Patients treated on the outpatient basis were older and with poorly controlled diabetes. Ambulatory treatment of diabetic foot is cheaper than their treatment as in-patients and the reimbursement from NHS is satisfactory.