Cechurová D, Lacigová S, Rusavý Z, Horáková N, Jankovec Z, Zourek M
I. interní klinika Lékarské fakulty UK a FN, Plzen.
Vnitr Lek. 2003 Jun;49(6):453-6.
The diabetic foot is one of the most expensive complications of diabetes mellitus.
To determine the direct costs of both inpatient and outpatient care of diabetic foot provided in Diabetic Centre University Hospital in Plzen.
42 patients with diabetic ulcers (45% neuropathic, 26% ischaemic and 29% mixed) who have attended the podiatric surgery from January to June 2000 were randomly selected. SUBJECT CHARACTERISTICS: 4 patients with type 1 diabetes, 38 patients with type 2 diabetes, mean of age 63 years (37-81), mean of duration of diabetes 17 years (1-31), mean of duration of diabetic ulcers 37 months (1-168) ulcers. Patients visited Diabetic Centre 9 times (5-13). 23 hospitalizations occurred in 17 patients (40%) with mean of 14 days duration (3-42). The AP-DRG (all patients diagnosis related groups) model was used to determine the hospital direct costs. The ambulatory costs included the reimbursed care, drugs (local treatment, antibiotics and antiagregans), bandages, patient transport and home care. Antidiabetic drugs and insulin or antihypertensive drugs were not included.
Total direct costs of diabetic foot care 42 patients were 1,440.600.-CK, 34.500.-CK (6.300.-CK-190.200.-CK)/patient in Diabetic Centre Plzen during 6 months. 37% of total costs (533.000.-CK), resp. 12.500.-CK (5.900.-CK -45.700.-CK)/patient represented ambulatory and 63% of total cost (907 600.-CK), resp. 53.700.-CK (18.000.CK-180.600.-CK)/patient hospital care.
糖尿病足是糖尿病最昂贵的并发症之一。
确定比尔森大学医院糖尿病中心提供的糖尿病足住院和门诊护理的直接费用。
随机选取2000年1月至6月在足病外科就诊的42例糖尿病溃疡患者（45%为神经病变型，26%为缺血型，29%为混合型）。受试者特征：4例1型糖尿病患者，38例2型糖尿病患者，平均年龄63岁（37 - 81岁），平均糖尿病病程17年（1 - 31年），糖尿病溃疡平均病程37个月（1 - 168个月）。患者就诊糖尿病中心9次（5 - 13次）。17例患者（40%）发生23次住院，平均住院时长14天（3 - 42天）。采用AP - DRG（所有患者诊断相关组）模型确定医院直接费用。门诊费用包括报销的护理、药物（局部治疗、抗生素和抗血小板药物）、绷带、患者交通和家庭护理。不包括抗糖尿病药物、胰岛素或抗高血压药物。
2000年6个月期间，比尔森糖尿病中心42例糖尿病足患者护理的总直接费用为1440600捷克克朗，每位患者34500捷克克朗（6300捷克克朗 - 190200捷克克朗）。总费用的37%（533000捷克克朗），即每位患者12500捷克克朗（5900捷克克朗 - 45700捷克克朗）为门诊费用，总费用的63%（907600捷克克朗），即每位患者53700捷克克朗（18000捷克克朗 - 180600捷克克朗）为住院护理费用。
