title: Economic analysis of soft-heel casting for diabetic foot ulcer: prevention and treatment.
abstract: OBJECTIVE
  To model the benefit of an innovative measure to manage patients with diabetes and a foot ulcer, or at high risk of ulceration, using a soft-heel casting, which can be applied by a podiatrist or other trained staff member and used in the hospital or community setting.
  
  
  METHODS
  An audit of the patient outcomes associated with the casting at NHS Borders was undertaken for inpatients with ulcers. These data were combined with other published data and expert opinion to model the benefit of the casting for prevention and curative purposes compared to standard practice. Cost of healed and unhealed ulcers in various settings was estimated based on the treatment pathways adopted.
  
  
  RESULTS
  The data from the economic model suggest that soft-heel castings could reduce the costs of managing these patients by approximately 10%; about £500 per inpatient and £425 per outpatient with an ulcer, and £205 per high-risk patient, when used for prevention.
  
  
  CONCLUSIONS
  This cost-consequence analysis suggests the intervention could save about 10% of costs for managing patients with an active ulcer in inpatients or outpatients and offers potential savings if used as a preventive measure. Further studies are required to confirm the estimated clinical benefit and reduced resource use.
authors.affiliation: York Health Economics Consortium, University of York, UK. joyce.craig@york.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Craig
authors.forename: R
authors.initials: R
authors.lastname: Shenton
authors.forename: A
authors.initials: A
authors.lastname: Smith
mesh_terms: D000368:Aged; D002370:Casts, Surgical / Q000191:economics*; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000191:economics / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D061826:Foot Orthoses / Q000191:economics; D017048:Health Care Costs; D006365:Heel; D006801:Humans; D008297:Male; D017059:Models, Econometric; D012606:Scotland; D012775:Shoes / Q000191:economics