Economic impact of diabetic foot ulcers on healthcare in Saudi Arabia: a retrospective study

Abstract

BACKGROUND: Diabetic foot ulcers (DFU) are a critical complication of diabetes mellitus (DM) affecting life quality and significantly impacting healthcare resources. OBJECTIVE: Determine the direct medical costs associated with treating DFU in King Fahad Hospital of the University and identify factors that could assist in developing resource management guidelines in Saudi Arabia. DESIGN: Retrospective study. SETTING: SETTING: King Fahad Hospital of the University, Al-Khobar, Saudi Arabia. PATIENTS AND METHODS: The study included diabetic patients admitted with foot ulcerations between 2007 and 2017 inclusive. We determined management costs including drug usage, wound dressings, surgical procedures, admissions, and basic investigation. MAIN OUTCOME MEASURES: Factors affecting the direct perspective medical costs of managing DFU. SAMPLE SIZE: 99 patients. RESULTS: The overall cost of managing 99 patients with DFU was 6 618 043.3 SAR ($1 764 632.68 USD), which further translates to approximately 6684.9 SAR per patient/year ($1782.6 USD). The highest cost incurred was for admission expenditure (45.6%), followed by debridement (14.5%) and intensive care unit (ICU) admission (10.4%). CONCLUSION: The overall healthcare expenditure in treating DFU is high, with hospital admissions and surgical procedures adding a significant increase to the total cost. Focused patient education on overall glycemic control and prevention of DFU may decrease complications and hence, the overall cost. LIMITATIONS: Identified only the direct medical costs of DFU as the indirect costs were subjective and more difficult to quantify. CONFLICT OF INTEREST: None.

Effects of Methanolic Extract Based-Gel From Saudi Pomegranate Peels With Enhanced Healing Potential on Excision Wounds in Diabetic Rats

“…Diabetes mellitus is increasing at an unprecedented pace in Saudi Arabia, patients with type-2 diabetes (T2D) are often affected by delayed healing that develops into chronic wounds, diabetic foot ulcers, and may result in complications, including gangrene and limb amputation. These wound healing complications have an effect on both the quality of treatment and the cost of healthcare (Alshammary et al, 2020).…”

Extent of awareness of diabetic foot care in diabetic patients and their families at AL Baha city, Saudi Arabia

“…Diabetic foot is a result of a pathophysiology includes both macro and micro-vascular diseases (Solan et al, 2017;Tork & Elgazzar, 2020). Diabetes related foot complications have been identified as the single most common cause of morbidity among diabetic patients (Lim et al, 2017) and it is significantly impacting health care resource (Alshammary et al, 2020).…”

Diabetic foot ulcers: treatment overview and cost considerations

“…2,51 DFU costs encompass direct and indirect costs. Direct medical costs can be attributed to hospital admissions, emergency department visits, outpatient visits, home care, diagnostic testing, procedures, dressings, and antibiotics, [52][53][54] whereas indirect costs are a result of reduced productivity and premature mortality. 55 In general, hospital admissions and longer durations of stay account for the largest segment of healthcare expenditure.…”

“…55 In general, hospital admissions and longer durations of stay account for the largest segment of healthcare expenditure. 53 Indeed, when compared with other healthcare utilisation resources, including medications, hospital admissions have the highest unit costs. 56 Therefore, cost-effective measures are necessary to reduce intervention costs in treating DFUs and thus decrease the economic burden associated with them.…”