Economic Impact of the Implementation of a Multidisciplinary Diabetic Foot Clinic in a Tertiary Hospital

Abstract

Objective: Diabetes and Diabetic Foot represent a major global burden for patients and the healthcare system. Multidisciplinary Diabetic Foot Clinics have been shown to be an effective therapeutic model for reducing major amputations and mortality rates. The aim of this article is to assess the economic impact of the implementation of a Multidisciplinary Diabetic Foot Clinic in a tertiary hospital in Catalonia.Methods: Retrospective observational cost-benefit study of all subjects with diabetes admitted with the diagnosis of a major amputation due to Diabetic Foot from 2010 to 2020. Direct and indirect costs were compared before and after the introduction of the Multidisciplinary Diabetic Foot Clinic, considering the probability of Emergency Room visits, Diabetic Foot Clinic visits, hospitalizations and outpatient clinic consultations for patients with Diabetic Foot. Results: The individual cost per Diabetic Foot patient was €14,768 before the implementation of the unit, with over 50% of the cost attributed to hospitalization and almost 20% to the costs associated with the morbidity caused by an amputation. After the implementation of the clinic, the expected cost was reduced to €5,985 due to a 40% reduction in the probability of hospitalization, which is the main factor contributing to cost savings. Overall, the implementation of the clinic resulted in cost savings per patient valued at €8,783, of which, €7,165 are related to hospital benefits. Conclusion: The results of this analysis contributes to the evidence suggesting that Multidisciplinary Diabetic Foot Clinics are cost-effective, by demonstrating that they have a positive impact on patient health while also reducing the utilization of healthcare resources.