Cost Comparison: Limb Salvage Versus Amputation in Diabetic Patients

NewsBot · Mar 16, 2013

Members do not see these Ads. Sign Up.
Cost Comparison: Limb Salvage Versus Amputation in Diabetic Patients With Charcot Foot.
Gil J, Schiff AP, Pinzur MS.
Foot Ankle Int. 2013 Mar 14.

BACKGROUND:
The negative impact on health-related quality of life in patients with Charcot foot has prompted operative correction of the acquired deformity. Comparative effectiveness financial models are being introduced to provide valuable information to assist clinical decision making.

METHODS:
Seventy-six patients with Charcot foot underwent operative correction with the use of circular external fixation. Thirty-eight (50%) had osteomyelitis. A control group was created from 17 diabetic patients who successfully underwent transtibial amputation and prosthetic fitting during the same period. Cost of care during the 12 months following surgery was derived from inpatient hospitalization, placement in a rehabilitation unit or skilled nursing facility, home health care including parenteral antibiotic therapy, physical therapy, and purchase of prosthetic devices or footwear.

RESULTS:
Fifty-three of the patients with limb salvage (69.7%) did not require inpatient rehabilitation. Their average cost of care was $56,712. Fourteen of the patients with amputation (82.4%) required inpatient rehabilitation, with an average cost of $49,251.

CONCLUSIONS:
Many surgeons now favor operative correction of Charcot foot deformity. This investigation provides preliminary data on the relative cost of transtibial amputation and prosthetic limb fitting compared with limb salvage. The use of comparative effectiveness models such as this simple attempt may provide valuable information in planning resource allocation for similar complex groups of patients.
Click to expand...

Admin2 · Mar 16, 2013

Related Threads
Other threads tagged with diabetic foot epidemiology
Regional variation on diabetic foot ulcer spending
Costs of diabetic foot complications

NewsBot · Jun 11, 2013

Impact of diabetes on costs before and after major lower extremity amputations in Germany
Falk Hoffmann et al
Journal of Diabetes and its Complications; Available online 7 June 2013

Aims
To compare direct medical costs 1 year before up to 3 years after first major lower extremity amputation (LEA) between patients with and without diabetes.

Methods
We used health insurance claims data and included patients with a first major LEA between 2005 and 2009. Costs for hospitalization, rehabilitation, outpatient care, outpatient drug prescriptions, non-physician services, durable medical equipment and long-term care were assessed. We estimated cost ratios (CR) for diabetes status using generalized linear models adjusted for age, sex, amputation level, care dependency as well as observation time and mortality within the corresponding period and costs before LEA.

Results
We included 444 patients with first major LEA (58.3% had diabetes), 71.8% were male and the average age was 69.1 years. Total mean costs for 1 year before LEA were higher in patients with diabetes (24,504 vs. 18,961 Euros), which was also confirmed by the multivariate analysis (CR: 1.27; 95% CI: 1.06–1.52). Costs up to 24 weeks after LEA were virtually the same in both groups (36,686 vs. 35,858 Euros), but thereafter differences increase again with higher costs for diabetics. Costs for 3 years after LEA were 115,676 vs. 92,862 Euros, respectively (CR: 1.26; 95% CI: 1.12–1.42). Hospitalizations accounted for more than 50% of total costs irrespective of diabetes status and period.

Conclusions
Costs up to 24 weeks after first major LEA are mainly driven by the amputation itself irrespective of diabetes. Thereafter, costs for diabetic patients were higher again, which underlines the importance of studying long-term costs.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

The factory supplies directly and provides cost-effective professional shoe OEM (ODM) and developmen

Economic cost of running injury

The Design and Validation of a Low-cost Foot Measurement System

coricosteriod injections

Effectiveness of Foot Orthoses Versus Corticosteroid Injection for Plantar Heel Pain

The absurdly high cost of insulin, explained

Adverse effects of corticosteroid injections

Share This Page