Ragnarson Tennvall Gunnel, Apelqvist Jan
IHE, the Swedish Institute for Health Economics, Lund, Sweden.
Clin Infect Dis. 2004 Aug 1;39 Suppl 2:S132-9. doi: 10.1086/383275.
Diabetic foot complications result in huge costs for both society and the individual patients. Few reports on the health-economic consequences of diabetic foot infections have been published. In studies considering a wide societal perspective, costs of antibiotics were relatively low, whereas total costs for topical treatment were high relative to the total costs of foot infections. Total direct costs for healing of infected ulcers not requiring amputation are approximately 17,500 dollars (in 1998 US dollars), whereas the costs for lower-extremity amputations are approximately 30,000 dollars-33,500 dollars depending on the level of amputation. Prevention of foot ulcers and amputations by various methods, including patient education, proper footwear, and foot care, in patients at risk is cost effective or even cost saving. Awareness of the potential influence of reimbursement systems on prevention, management, and outcomes of diabetic foot lesions has increased. Despite methodological obstacles, modeling studies are needed in future health-economic evaluations to determine the cost effectiveness of various strategies.
糖尿病足并发症给社会和患者个人都带来了巨大的成本。关于糖尿病足感染的健康经济后果的报道很少。在考虑广泛社会视角的研究中,抗生素成本相对较低,而局部治疗的总成本相对于足部感染的总成本较高。无需截肢的感染性溃疡愈合的直接总成本约为17,500美元(以1998年美元计),而下肢截肢的成本约为30,000美元至33,500美元,具体取决于截肢水平。通过各种方法,包括患者教育、合适的鞋类和足部护理,对高危患者预防足部溃疡和截肢具有成本效益,甚至可以节省成本。人们对报销系统对糖尿病足病变的预防、管理和结果的潜在影响的认识有所提高。尽管存在方法上的障碍,但在未来的健康经济评估中仍需要进行建模研究,以确定各种策略的成本效益。