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糖尿病足溃疡成本的经济学评估:一项针对239例患者的回顾性研究结果

An economic evaluation of the cost of diabetic foot ulcers: results of a retrospective study on 239 patients.

作者信息

Girod I, Valensi P, Laforêt C, Moreau-Defarges T, Guillon P, Baron F

机构信息

Mapi Values, Lyon, France.

出版信息

Diabetes Metab. 2003 Jun;29(3):269-77. doi: 10.1016/s1262-3636(07)70036-8.

Abstract

OBJECTIVE

To evaluate the cost of foot ulcers in diabetic patients.

METHODS

Retrospective pharmacoeconomic study using direct and indirect costs (sick leave days) from the perspective of French social security system.

RESULTS

239 patients were included in the study by 80 physicians who treat diabetic patients suffering from foot ulcers. Initially identified by telephone survey, these physicians were primarily endocrinologists/diabetologists, general practitioners and surgeons. Average monthly costs in the treatment of foot ulcers were 697 euro; for outpatient care, 1556.20 euro; for hospital care (day treatment and short stays), and 34.76 euro; for sick leaves. When hospitalization was required, it represented approximately 70% of the average cost for foot ulcers. The portion of outpatient costs was principally generated by medical and paramedical treatments, and interventions carried out by healthcare personnel. On the other hand, medication only represented 10% of total costs. The initial severity of the pathology was a determinant clinical factor of high healthcare costs. In addition, the more recent the lesion was, the higher the cost of treatment. Amputation and follow-up by specialists were correlated to high costs as well, a logical result of these clinical factors.

CONCLUSION

This analysis is the first to evaluate the cost of treating foot ulcers in such a large population of diabetic patients. The economic outcomes should help direct public authorities in their choices, particularly as regards the interest of treating these diabetes-related complications as early as possible.

摘要

目的

评估糖尿病患者足部溃疡的治疗成本。

方法

从法国社会保障体系的角度,采用直接和间接成本(病假天数)进行回顾性药物经济学研究。

结果

80位治疗糖尿病足部溃疡患者的医生纳入了239例患者进行研究。这些医生最初通过电话调查确定,主要是内分泌科医生/糖尿病专科医生、全科医生和外科医生。足部溃疡治疗的平均每月成本为697欧元;门诊护理为1556.20欧元;医院护理(日间治疗和短期住院)为34.76欧元;病假成本。需要住院治疗时,其占足部溃疡平均成本的约70%。门诊成本部分主要由医疗和辅助医疗治疗以及医护人员实施的干预措施产生。另一方面,药物仅占总成本的10%。病情的初始严重程度是高医疗成本的一个决定性临床因素。此外,病变越新,治疗成本越高。截肢和专科随访也与高成本相关,这是这些临床因素的合理结果。

结论

该分析首次在如此大量的糖尿病患者中评估了治疗足部溃疡的成本。经济结果应有助于指导公共当局做出选择,特别是在尽早治疗这些糖尿病相关并发症的益处方面。

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