Economic burden of illness associated with diabetic foot ulcers in Canada

Abstract

BackgroundThe primary objective was to estimate the national burden of illness in Canada for diabetic foot ulcer (DFU) for 2011. Secondary objectives included estimating the national incidence and prevalence of DFU, and the 3-year average cost for DFU incident cases.MethodsAnalyses were conducted using four national databases for the period April 1, 2006 to March 31, 2011, with cases being identified by ICD-10 CA codes. Resource utilization and costs, expressed in 2011 Canadian dollars, were estimated for DFU-related hospitalizations, emergency care (ER), same day surgeries, home care, long term care, physician visits and caregiver time losses.ResultsIn Canada in the year 2011, DFU was associated with 16,883 hospital admissions (327,140 days), 31,095 ER or clinic visits, 41,367 rehabilitation clinic visits, and 26,493 interventions, including 6,036 amputations and 5,796 surgical debridements. This acute institution care represented $320.5 M, and with an additional $125.4 M for home care and $63.1 M for long term care, the annual cost associated with DFU-related care was $547.0 M, or $21,371 annual cost per prevalent case. In 2011, the national prevalence of DFU was 25,597 cases (75.1 per 100,000 population), consisting of 16,161 men (63.1%) and 9,436 women (36.9%), and an estimated 14,449 incident cases. For an incident case of DFU, the average 3-year cumulative cost was $52,360.ConclusionThe annual burden for DFU cases that have at least one admission or ER/clinic visit over a 5 year period is higher than previously reported.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0687-5) contains supplementary material, which is available to authorized users.

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

“…also increases the cost of illness as these patients have to buy drugs for these ailments which also need to be adequately controlled for a successful healing of the diabetic foot ulcer. Hopkins et al found comorbidities to significantly escalate the cost of diabetic foot ulcer in the Canadian study [28]. In a Medicare study in 1995, $3609 per patient per year was spent to treat foot ulcer, 74% of the spending was for inpatient hospital stay, 11.9% for outpatient services, 11.4% homecare and 4% for hospice.…”

“…A study done in Europe by van Acker et al found that hospitalization accounted for more than 41% of the total cost of illness [27]. In 2011, in Canada, the resource utilization associated with diabetic foot ulcer for acute institutional care was $3586.6million of which $320.50 million was for admission (89%), $19.1 million for emergency and clinic visits (5%) and an additional $19.0million for interventions [28]. A retrospective pharmacoeconomic study using direct and indirect costs from the perspective of French social security system found that hospitalization represented 70% of the average cost for foot ulcers [29].…”

Illiteracy and diabetic foot complications

“…These complications are a frequent reason of hospital admission and impose excessive distress and expenses [2][3][4][5][6][7][8]. Diabetic neuropathy and vasculopathy can lead to loss of foot sensation, foot deformities (resulting in pressure points and ulcerations), increased susceptibility to infections (including osteomyelitis), and gangrene.…”

Evaluation of wound fluid biomarkers to determine healing in adults with venous leg ulcers: A prospective study

“…Chronic wounds due to venous disease are a significant health care burden due to their high incidence, delayed healing and reoccurrence rates . Venous leg ulcers (VLU) occur in 2% of adults over 60 and significant impaired wound healing is a central issue as 24% of VLUs exist longer than a year with a 70% recurrence rate .…”