title: The economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers.
abstract: BACKGROUND
  We sought to examine the economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers by evaluating cost outcomes for patients with diabetic foot ulcer who did and did not receive care from a podiatric physician in the year before the onset of a foot ulcer.
  
  
  METHODS
  We analyzed the economic value among commercially insured patients and Medicare-eligible patients with employer-sponsored supplemental medical benefits using the MarketScan Databases. The analysis consisted of two parts. In part I, we examined cost or savings per patient associated with care by podiatric physicians using propensity score matching and regression techniques; in part II, we extrapolated cost or savings to populations.
  
  
  RESULTS
  Matched and regression-adjusted results indicated that patients who visited a podiatric physician had $13,474 lower costs in commercial plans and $3,624 lower costs in Medicare plans during 2-year follow-up (P < .01 for both). A positive net present value of increasing the share of patients at risk for diabetic foot ulcer by 1% was found, with a range of $1.2 to $17.7 million for employer-sponsored plans and $1.0 to $12.7 million for Medicare plans.
  
  
  CONCLUSIONS
  These findings suggest that podiatric medical care can reduce the disease and economic burdens of diabetes.
authors.affiliation: Health Outcomes, Thomson Reuters, Ann Arbor, MI 48108, USA.
authors.forename: Ginger S
authors.initials: GS
authors.lastname: Carls
authors.forename: Teresa B
authors.initials: TB
authors.lastname: Gibson
authors.forename: Vickie R
authors.initials: VR
authors.lastname: Driver
authors.forename: James S
authors.initials: JS
authors.lastname: Wrobel
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Garoufalis
authors.forename: Roy R
authors.initials: RR
authors.lastname: Defrancis
authors.forename: Shaohung
authors.initials: S
authors.lastname: Wang
authors.forename: J Erin
authors.initials: JE
authors.lastname: Bagalman
authors.forename: James R
authors.initials: JR
authors.lastname: Christina
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000191:economics / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D008875:Middle Aged; D010820:Physicians / Q000191:economics*; D011032:Podiatry / Q000191:economics; D012189:Retrospective Studies; D014481:United States; D000078329:Workforce; D055815:Young Adult