title: The cost utility of a multi-disciplinary foot protection clinic (MDFPC) in an Irish hospital setting.
abstract: BACKGROUND
  Foot ulceration which may result in lower limb amputation is one of the most feared complications among patients with diabetes and the prevention of both ulceration and amputation is a major challenge facing the health service. Many studies have proposed dedicated diabetic foot teams as the future of diabetic foot care.
  
  
  OBJECTIVE
  We aimed to quantify the cost benefit and sustainability of a multi-disciplinary foot protection clinic (MDFPC) in an Irish university hospital setting.
  
  
  METHODS
  A dedicated bi-weekly consultant-led MDFPC including Vascular Surgery, Endocrinology, Orthopaedic Surgery, Podiatry, Orthotics and Tissue Viability was established in June 2008.
  
  
  RESULTS
  Between 2006 and 2010, a total of 221 lower limb procedures (major/minor amputations and debridement) were performed. The number of major amputations decreased from 12 during the control period (2 years before the clinic) to 7 in the study period (2 years after the clinic). After costing all activity associated with the clinic, there was an overall saving of €114,063 per year associated with the introduction of the MDFPC.
  
  
  CONCLUSIONS
  This is the first study in an Irish context, and one of few international studies, to demonstrate that an aggressive-coordinated approach to diabetic foot care is both cost effective and clinically efficient in reducing the burden of foot-related complications in a diabetic population.
authors.affiliation: Department of Vascular Surgery, Adelaide and Meath (incorporating the National Children's) Hospital, Tallaght, Dublin 24, Ireland. nasong@tcd.ie
authors.forename: G J
authors.initials: GJ
authors.lastname: Nason
authors.forename: H
authors.initials: H
authors.lastname: Strapp
authors.forename: C
authors.initials: C
authors.lastname: Kiernan
authors.forename: K
authors.initials: K
authors.lastname: Moore
authors.forename: J
authors.initials: J
authors.lastname: Gibney
authors.forename: T M
authors.initials: TM
authors.lastname: Feeley
authors.forename: B
authors.initials: B
authors.lastname: Egan
authors.forename: S
authors.initials: S
authors.lastname: Tierney
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000191:economics; D000671:Amputation, Surgical / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000150:complications / Q000191:economics / Q000601:surgery*; D005260:Female; D005528:Foot / Q000601:surgery*; D006801:Humans; D007494:Ireland; D023821:Limb Salvage / Q000191:economics* / Q000379:methods; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*