title: Cost-effectiveness analysis of medical intervention in patients with early detection of diabetic foot in a tertiary care hospital in Bangladesh.
abstract: The economic burden resulting from diabetic foot consumes a major portion of resources. The study was undertaken to assess the cost-effectiveness of medical intervention in patients with diabetic foot. At baseline 906 patients were analyzed. Then 200 patients with diabetic foot were purposively selected from a tertiary diabetes care hospital. Of these, 100 were late in detection and poorly managed (late diabetic foot or LDF) and 100 were detected early and properly managed (early diabetic foot or EDF). Among 906 patients, 2.8% (25 patients) were found to develop diabetic foot. Total cost of treatment was US$13,308.16 with an average of US$443.60 per patient. Comparing the cost of patients who underwent amputation with the patients who are not yet amputated, cost difference was US$6657.74. The result showed that cost of amputation was 5.54 times higher than the usual treatment. The average cost of care was US$134 per patient. Among the average annual cost, LDF consumed US$18,918. Fifty percent of the costs were attributable to drugs for both groups of which 77% was for LDF and 29% to hospitalizations. The regression equation showed that medical cost is significantly related to complications. Proper management can substantially reduce the cost of care of patients with diabetic foot.
authors.affiliation: Health Economics Unit, DAB, Dhaka, Bangladesh. dhcdp@dab-bd.org
authors.forename: Samira Humaira
authors.initials: SH
authors.lastname: Habib
authors.forename: Kazal Boron
authors.initials: KB
authors.lastname: Biswas
authors.forename: Salima
authors.initials: S
authors.lastname: Akter
authors.forename: Soma
authors.initials: S
authors.lastname: Saha
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
mesh_terms: D000671:Amputation, Surgical / Q000191:economics; D001459:Bangladesh; D016022:Case-Control Studies; D018890:Chemoprevention / Q000191:economics; D015331:Cohort Studies; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D017719:Diabetic Foot / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D042241:Early Diagnosis; D005260:Female; D006760:Hospitalization / Q000191:economics; D006761:Hospitals; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome