Department of Health Economics and Statistics, Vice-Chancellor's Office in Treatment Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2024 Mar 21;24(1):363. doi: 10.1186/s12913-024-10873-9.
Diabetic foot ulcer (DFU) is known as a serious complication of diabetes mellitus in patients with diabetes, imposing heavy medical costs on healthcare systems due to its chronic nature. patients with severe diabetic foot ulcer are often disabled to work, and some of them may even die, leading to associated productivity losses. Since no previous study has investigated the economic burden of DFU in Iran, this study is to estimate the economic burden of diabetic foot disease in Iran.
In this descriptive cross-sectional study, randomly selected samples consisted of 542 patients with DFU, hospitalized in the hospitals of Shahid Beheshti University of Medical Sciences. The demographic profile and cost data used in this analysis were derived from a researcher-designed checklist. Lost productivity was calculated based on Human Capital Approach, and the total economic cost of DFU was determined using patient-level data on costs and prevalence data from the global burden of diseases reports. All analyses were performed using SPSS software (Version 23), and Microsoft Excel (Version 19).
The economic burden of DFU in Iran in two scenarios of discounting future costs and not discounting them was about $8.7 billion and $35 billion, respectively (about 0.59 and 2.41% of GDP). 79.25% of the estimated costs in this study were indirect costs and productivity losses, of which 99.34% (7,918.4 million Dollars) were productivity losses due to premature death. 20.75% (2,064.4 million dollars) of the estimated costs in this study were direct costs. The average length of stay (LOS) was 8.10 days (SD = 9.32), and 73.3% of patients recovered and were discharged after hospitalization and 7.6% died. The majority of the costs are imposed on the age group of 60-69 year (53.42% of the productivity lost due to hospital length of stay, 58.91% of the productivity lost due to premature death & 40.41% of direct costs).
DFU represents a heavy burden to patients, Iran's health system, and the economy. Early prevention strategies need to be prioritized in making public health policies. These policies and decisions can be in the area of changing lifestyle, health education, changing people's behavior, and encouraging physical activity that targeted high-risk populations in order to reduce the prevalence of diabetic foot and resulting substantial economic burden.
糖尿病足溃疡（DFU）是糖尿病患者的一种严重并发症，由于其慢性性质，给医疗系统带来了沉重的医疗费用负担。严重的糖尿病足溃疡患者往往无法工作，其中一些甚至可能死亡，导致相关的生产力损失。由于以前没有研究调查过 DFU 在伊朗的经济负担，因此本研究旨在估计伊朗糖尿病足疾病的经济负担。
在这项描述性的横断面研究中，随机选择了 542 名患有 DFU 的患者作为样本，这些患者住院于沙希德贝赫什提大学医学科学的医院。本分析中使用的人口统计学特征和成本数据来自研究人员设计的检查表。基于人力资本方法计算了生产力损失，使用基于患者层面的成本数据和全球疾病负担报告中的患病率数据，确定了 DFU 的总经济成本。所有分析均使用 SPSS 软件（版本 23）和 Microsoft Excel（版本 19）进行。
在考虑未来成本贴现和不贴现的两种情况下，伊朗 DFU 的经济负担分别约为 87 亿美元和 350 亿美元（分别占 GDP 的 0.59%和 2.41%）。本研究估计的成本中，79.25%为间接成本和生产力损失，其中 99.34%（7918400 万美元）为因过早死亡导致的生产力损失。本研究估计的成本中，20.75%（2064400 万美元）为直接成本。平均住院时间（LOS）为 8.10 天（SD=9.32），73.3%的患者在住院后康复并出院，7.6%的患者死亡。大部分成本发生在 60-69 岁年龄组（由于住院时间导致的生产力损失的 53.42%，由于过早死亡导致的生产力损失的 58.91%和直接成本的 40.41%）。
DFU 给患者、伊朗的卫生系统和经济带来了沉重的负担。在制定公共卫生政策时，需要优先考虑早期预防策略。这些政策和决策可以涉及改变生活方式、健康教育、改变人们的行为和鼓励针对高危人群的体育活动，以降低糖尿病足的患病率和由此产生的巨大经济负担。
