The direct cost of diabetic foot management in some of private hospitals in Jeddah, Saudi Arabia
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IGINAL ARTICLE
The direct cost of diabetic foot management in some of private hospitals in Jeddah, Saudi Arabia Hasan Ali Alzahrani
Received: 2 December 2011 / Accepted: 27 November 2012 / Published online: 22 December 2012 # Research Society for Study of Diabetes in India 2012
Abstract The direct cost of managing diabetic foot disorders DFDs is considerably high, particularly when patients need hospital admission and subsequent surgical interventions. Nothing has been published on the cost of treating DFDs in Saudi Arabia (SA). The current study aims to estimate the direct cost of hospitalization and forecast the future costs across the country. The records of all patients admitted in the year 2008 in 4 private hospitals in Jeddah, SA with the diagnosis of DFDs were reviewed retrospectively. The total cost which was actually paid out-of-pocket by the patients or reimbursed by insurance bodies to cover the hospitalization period was recorded. Other indirect costs such as cost of ambulatory/home care and rehabilitation were not included for logistic reasons. A total of 88 patients’ records were reviewed. The mean age of patients was 58.5±11.6 years. The median cost of hospitalization was SAR 12,819.5 which equals to USD 3,418 (SAR range 1,936 – 544,007). The highest median cost was reported in patients who had major amputations and the lowest for those on conservative treatment. However, linear regression for predictors of higher cost revealed that the longer hospital stay was the most statistically significant predictor. The findings of this retrospective study indicates the importance of reducing the hospital stay by improving the primary prevention program, multidisciplinary collaboration and ambulatory care services in SA and similar developing countries. Larger scale prospective studies are certainly needed particularly in less-developed countries with high prevalence rates of DM. Keywords Diabetes mellitus . Foot . Cost . Hospitalization . Amputation . Developing countries
H. A. Alzahrani (*) Department of Surgery, Faculty of Medicine, King Abdulaziz University, P. O. Box 53100, Jeddah 21583, Saudi Arabia e-mail: [email protected]
Introduction Foot disorders are among the most feared chronic complications of DM [1–3]. The term diabetic foot disorders (DFDs) refers to a group of disorders which clinically present with one or more of the following clinical manifestations: foot ulceration, infection, neuropathy, deformity, gangrene and/or ischemia [2]. All or some of these clinical presentations may overlap in same patients and frequently affect both the feet. The annual incidence of diabetic foot ulceration varies between 2.1 to 7.4 % [4] and the lifetime risk of developing a diabetic foot ulcer has been estimated to be as high as 25 % [5]. If not timely and properly managed, the ultimate endpoint of diabetic foot ulcer is amputation in 15–27 % [4–6]. Furthermore, when amputation happens, it is usually associated with significant morbidity [4, 6, 7], mortality [4, 5, 7], in addition to immense social, psycholo
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