Hospitalisation Cost of Patients with Diabetic Foot Ulcers in Valencia (Spain) in the Period 2009⁻2013: A Retrospective Descriptive Analysis.

Pilar Nieto-Gil,Manuel Cobo-Najar,Manuel Pardo-Rios,Carlos Blasco-Garcia,Gabriel Gijon-Nogueron,Ana Belen Ortega-Avila

doi:10.3390/ijerph15091831

Abstract

Ulcers are the main cause of hospitalisation and clinical complications in patients with diabetes. We analyse the length and cost of hospital stay of patients with diabetic foot ulcers, taking into consideration that hospitalisation and, if necessary, amputation represent the greatest area of expense to the healthcare system for such patients. This analysis focuses on the treatment provided to these patients in public hospitals in the region of Valencia (Spain), registered in the Spanish Minimum Basic Data Set, during the period 2009–2013. The number of acute hospital admissions in this respect is increasing and has a high socioeconomic cost. During the study period, there were over 2700 hospital admissions, an average of nearly 550 per year. The total hospital stay for these patients was 30,886 days, with an average of 11.4 days and a cost of €7633 per admission. Preventive policies and the deployment of multidisciplinary teams are essential to reduce these costs and avoid future complications such as amputation.

Highlights

The 2007 International Consensus on the Diabetic Foot, edited by the International WorkingGroup on the Diabetic Foot, defines diabetic foot (DF) as the infection, ulceration and destruction of deep tissues, associated with neurological abnormalities and peripheral vasculopathy of diverse severity in the lower extremities, as a result of the interaction of factors induced by sustained and uncontrolled hyperglycaemia.The most common cause of complications and hospitalisation in diabetic patients are those associated with DF
DF ulcer is a clinical alteration of neuropathic aetiopathogenic origin, arising from sustained hyperglycaemia, with or without concurrent ischaemia and/or previous traumatic trigger, injury to and/or ulceration of the foot [3]
Descriptive, ecological and observational study, the Minimum Basic Data Set (MBDS) was analysed with respect to the period 1 January 2009 to 31 December 2013, to extract statistical data related to patients with DF admitted to public acute care hospitals in the region of Valencia (Spain)

Summary

Introduction

The 2007 International Consensus on the Diabetic Foot, edited by the International WorkingGroup on the Diabetic Foot, defines diabetic foot (DF) as the infection, ulceration and destruction of deep tissues, associated with neurological abnormalities and peripheral vasculopathy of diverse severity in the lower extremities, as a result of the interaction of factors induced by sustained and uncontrolled hyperglycaemia.The most common cause of complications and hospitalisation in diabetic patients are those associated with DF. Group on the Diabetic Foot, defines diabetic foot (DF) as the infection, ulceration and destruction of deep tissues, associated with neurological abnormalities and peripheral vasculopathy of diverse severity in the lower extremities, as a result of the interaction of factors induced by sustained and uncontrolled hyperglycaemia. 15% of diabetic patients will develop a foot or leg ulcer during their illness [1]. Of these cases, 85% will require amputation, an outcome that represents. DF ulcer is a clinical alteration of neuropathic aetiopathogenic origin, arising from sustained hyperglycaemia, with or without concurrent ischaemia and/or previous traumatic trigger, injury to and/or ulceration of the foot [3]. The presence of diabetes increases the risk of ulceration and amputation by 25% [5]. DF ulcers mainly affect patients aged 45–65 years, who present an incidence of 15% [6]

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