Cost of Illness of Diabetic Foot Ulcer in a Resource Limited Setting: A Study from Northwestern Nigeria

Abstract

Introduction Diabetic foot ulcer is a major complication of diabetes with a high economic cost of managing. Data from resource limited setting will bring to light how patients in these localities suffer financially in addition to poverty and lack of health insurance. This study estimated cost of illness among patients with diabetic foot ulcer in northwestern Nigeria. Methods It was a hospital based cross-sectional study. Questionnaire was used to take the bio data and medical history. Direct medical, direct non-medical and indirect cost were estimated. Result Majority of the patients were males with the mean age of 59.3 ± 15.1 yrs. About 60% of the patients earn less than $100 monthly. The total cost of illness of diabetic foot ulcer was estimated at $140,735.56 (median = $1381.55 [IQR 1002.42-]). Direct cost of illness was $107,797.06 (median = $1023.27 [IQR 773.93-1568]), while the indirect cost was $32, ). Out of pocket payment accounted for 90% of the payment. Conclusion The cost of diabetic foot ulcer is very exorbitant and the patients affected are mostly poor, unemployed and the breadwinners of their families.

Out‐of‐pocket expenditure among patients with diabetic foot ulcer in a tertiary care hospital of south India: A cross‐sectional study

“…However, only 34.4% of the participants had undergone lower limb amputation and thus in a position to avail the insurance benefits. This observation concurs with the study by Muhammad et al, 13 where out-of-pocket payment accounted for 90% of the payment, despite health insurance coverage. This study highlights the deficiency in the current insurance schemes and underscores the need for schemes that adequately address the financial aspects of DFU management holistically.…”

“…The dearth of affordable insurance schemes and policies further escalates the colossal economic burden. 13 Multiple studies have highlighted prominent risk factors that predispose to DFUs and aid their progression and recurrence. These include male gender, duration of diabetes (more than 10 years), peripheral neuropathy, diabetic retinopathy and nephropathy, peripheral vascular disease, foot deformity, smoking, history of prior ulcers or amputations, poor glycaemic control, obesity, genetic and nutritional factors.…”

“…In India, DFUs are a significant financial burden owing to the recurring healthcare interventions required to manage them. The dearth of affordable insurance schemes and policies further escalates the colossal economic burden 13 …”

“…The dearth of affordable insurance schemes and policies further escalates the colossal economic burden. 13 …”

Indirect costs of non‐healing diabetic foot wounds in an African origin population in Barbados

“…While there is a paucity of published data on the costs of diabetic foot in developing countries, reports from Nigeria show that indirect costs associated with diabetic foot account for 25-30% of total foot-care costs, similar to findings out of the United States. 1,2 The Wound Healing Study is a case-control design from Barbados, a small-island developing state of 287,000 people. Cases were patients with diabetes with current non-healing foot wounds of >1 month duration and controls were patients with diabetes who never had a nonhealing foot wound.…”