Burden of Infected Diabetic Foot Ulcers on Hospital Admissions and Costs in a Third-Level Center

Abstract

Diabetic foot is a common complication of diabetes that affects quality and prognosis of life for patients and often requires hospitalization. Infection, alone or in association with ischemia, is the main cause of hospital admission and impacts prognosis. The aim of this study is to analyze the costs of diabetic foot lesions and assess factors that influence the economic impact, focusing on infection. We included all people with diabetes with a first visit for diabetic foot during 2018 in our diabetic foot center. Database interrogation identified 422 patients. Diabetic foot treatment required hospitalization for 242 patients (58%), while 180 (42%) were treated in outpatient services. Healing time was different between the two groups: it was 136 ± 124 days (mean ± SD) for outpatients and 194 ± 190 days for patients that require hospitalization (p < 0.001). Costs: Treatment of 422 patients for diabetic foot globally costs 2063 million EUR and the mean cost for patients is 4888 EUR, with hospital stay having a high impact on this, accounting for 88% of the costs. Infection impacts hospitalization duration and ischemia impacts healing time. Ischemia and infection prolonged hospitalization duration and costs. Our work underlines that hospital treatment costs have a high impact on total costs.

Keywords

• diabetic foot ulcer
• infection
• hospitalization
• peripheral arterial disease costs