Management of diabetic foot lesions in hospital: costs and benefits.
OBJECTIVE
The aim of this study was to evaluate the direct and indirect costs associated with diabetic-related foot lesions in patients hospitalized in a department of Endocrinology and Diabetology (36 beds).


METHODS
Direct costs included costs associated with hospital stay, laboratory testing, medical and surgical treatment. Lesions were classified in 3 groups (I, II, III) according to their importance (Wagner classification).


RESULTS
Among 1,779 admissions for diabetes, 163 (i.e., 9.16%) were related to a foot lesion. The stay in hospital for these lesions reached 7,247 days over a 5-year period, with an average stay duration of 45 days per lesion. Mean length of hospital stay varied according to the importance of the lesion: 26.87 days, 48.25 days, 57.12 days for group I, II and III, respectively. The total cost amounted to 914,534.39 US dollars and the mean cost 5,610.64 US dollars. Mean cost was 3,326.76, 5,712.24, 7,399.74 US dollars for group I, II and III, respectively. Nearly 80% of the financial costs were due to hospital stay. Primary healing occurred in 59.09% of the patients (n=78); 17.4% (n=23) of the patients required major amputation, 14.4% (n=19) minor amputation. Death rate reached 9.1% (n=12).


CONCLUSIONS
An increase in length of stay and costs with importance of the lesion was identified. The strategy of care of the diabetic lesions should be based upon the prevention of ulcer formation: it seems actually the best mean (the least expensive) in a developing country where financial resources are very limited. This prevention should be made through regular patient education, appropriately fitted shoes, and regular careful examination by a General Practitioner or a Diabetologist.
Benotmane
A
A
Service d'Endocrinologie-Diabétologie, Centre Hospitalo-Universitaire, Clinique Laribère, 27 rue J.M. Laribère, 31000 Oran, Algeria. benot@elbahia.cerist.dz
Mohammedi
F
F
Ayad
F
F
Kadi
K
K
Medjbeur
S
S
Azzouz
A
A
D000671:Amputation, Surgical; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D008297:Male