Economic burden of podiatric care for diabetic foot ulcers in the Czech Republic: A prospective multicenter study
Jazyk angličtina Země Irsko Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie
PubMed
40187534
DOI
10.1016/j.diabres.2025.112141
PII: S0168-8227(25)00155-X
Knihovny.cz E-zdroje
- Klíčová slova
- Costs, Diabetic foot, Diabetic foot ulcers, Economy, Epidemiology,
- MeSH
- diabetická noha * ekonomika terapie epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- náklady na zdravotní péči * MeSH
- osobní újma zaviněná nemocí * MeSH
- podiatrie * ekonomika MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
OBJECTIVE: Diabetic foot (DF), especially DF ulcers (DFUs) are a relatively frequent and financially burdensome late-stage complication of diabetes. However, data on the costs of podiatric care in the Czech Republic are scarce. The aim of this prospective multicenter study was to determine the total costs associated with long-term podiatric care in selected foot clinics across the Czech Republic. RESEARCH DESIGN AND METHODS: A total of 119 patients with DFUs (mean age of 68 ± 11 years, diabetes duration of 19 ± 11 years, HbA1c level of 62 ± 14 mmol/mol, composite WIfI score of 3 ± 2, 33 % had new DFUs, 37 % previous amputations, and 50 % had peripheral artery disease (PAD)) from 10 podiatric foot clinics in the Czech Republic were enrolled in our financial analysis. Direct and indirect costs associated with podiatric care - diagnostic and treatment methods - including angiological, radiological, and microbiological examinations, blood sampling, prescribed materials for local therapy, antibiotics, surgical procedures, offloading devices, hospital services and additional expenses such as patient transportation, doctors' visits, home care assistance, and work incapacity - were monitored over a 6-month period using an electronic database. RESULTS: The average cost of podiatric care per patient over a 6-month period was €2,506 with median €1,320. The largest expenses were spent on therapeutic procedures (51.4 %). Costs for patients hospitalized during the study period were significantly higher than for outpatients (€7,923 vs. €1,304 on average; P < 0.001). Among hospitalized patients, the main costs were hospital services (32 %), therapeutic procedures (26 %), and antibiotic and local therapies (20 %). Among outpatients, therapeutic procedures accounted for 74 % of the total costs. Newly developed DFUs or PAD were not linked to significantly increased costs. The composite WIfI score, primarily the wound component, was the only parameter that significantly positively correlated with the total podiatric costs (r = 0.434; 95 % CI 0.279-0.559; P < 0.0001). Other patient characteristics such as age, diabetes duration, DFU duration, and HbA1c level did not show significant cost correlations. CONCLUSIONS: On average, podiatric care for patients with DFUs in the Czech Republic is 3 to 9 times more expensive than standard diabetes healthcare. The expenses for hospitalized patients are almost 6 times higher than for outpatients. The composite WIfI score was the most significant indicator of podiatric financial burden.
Department of Data Science Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Internal Medicine and Cardiology Ostrava University Hospital Ostrava Czech Republic
Diabetology and Podiatry Outpatient Clinic Dr Pírek Clinic Mladá Boleslav Czech Republic
Diabetology and Podiatry Outpatient Clinic Příbram Regional Hospital Příbram Czech Republic
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