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. 2020 Nov 10:13:4249-4260.
doi: 10.2147/DMSO.S275814. eCollection 2020.

Cost of Diabetic Foot Ulcer Management in China: A 7-Year Single-Center Retrospective Review

Qingwei Lu  1 , Jun Wang  1 , Xiaolu Wei  2 , Gang Wang  1 , Yang Xu  1 , Zengzhen Lu  1 , Peng Liu  1
Affiliations

Cost of Diabetic Foot Ulcer Management in China: A 7-Year Single-Center Retrospective Review

Qingwei Lu et al. Diabetes Metab Syndr Obes. .

Abstract

Background: The cost of care for diabetic foot ulcers has became a global economic burden. The study aimed to analyze diabetic foot ulcer cost changes over time and to identify factors associated with these variables, so as to strengthen and improve the management of diabetic foot ulcers.

Methods: We retrospectively analyzed the data in the electronic medical record system of our wound treatment center. The homepage of the system was queried using the national clinical version 2.0 disease diagnosis code (ICD-10), the data of patient's basic information were exported. Through the statistics and analysis of these data, the socioeconomic changes and possible risk factors of diabetic foot ulcers management in recent years were obtained.

Results: There were 3654 patients included in the study, an average of 522 per year. The total cost per patient increased from ¥15,535.58 in 2014 to ¥42,040.60 in 2020, with an average of ¥21,826.91. The average length of stay between 14.29 days and 31.4 days from 2014 to 2020, with an average of 18.10 days. Besides, the average incidence of peripheral arterial disease in diabetic foot ulcers patients admitted was as high as 81.9%, and the average amputation rate was 9.9%. The study reflected the total cost and length of stay of diabetic foot patients increased significantly from 2014 to 2020, which were related to age (>85 years), gender (male), peripheral arterial disease, amputation (P < 0.05).

Conclusion: A heavy cost from diabetic foot ulcers and its complications was significantly increased yearly, which was related to older age, co-morbidity, amputation and duration of hospitalization. The prevention and treatment of diabetic foot ulcers have a long way to go, early comprehensive prevention and multi-disciplinary cooperation may still be an effective way.

Keywords: cost; diabetic foot ulcers; electronic medical record system; multi-disciplinary; retrospective analysis; socioeconomic.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process.
Figure 2
Figure 2
The average total cost, drug cost, inspection cost, and surgery cost per patient, by year groups.
Figure 3
Figure 3
Correlation test. Spearman correlation coefficient. r: 0.90–1.00, very high positive correlation. r: 0.70–0.90, high positive correlation; r: 0.50–0.70, moderate positive correlation; r: 0.00–0.30, negligible correlation. (A) Drug cost vs total cost; (B) inspection cost vs total cost; (C) surgery cost vs total cost.
Figure 4
Figure 4
Total cost by age groups.
Figure 5
Figure 5
Total cost by amputation groups.
Figure 6
Figure 6
Total cost by PAD groups.
Figure 7
Figure 7
The average length of stay by year groups.
Figure 8
Figure 8
Linear equation between total cost and length of stay.
Figure 9
Figure 9
Length of stay by gender groups.
Figure 10
Figure 10
Length of stay by amputation and non-amputation groups.
Figure 11
Figure 11
Forest plot of amputation risks.
See this image and copyright information in PMC

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Grants and funding

This research was funded by the National Natural Science Foundation of China (81973854, 81473685) and Ministry of Science and Technology of China (2008BAI53B01, 2008BAI53B011).