Cost-based Comparative Analysis of Diabetic Hand Ulcers and Diabetic Foot Ulcers

Yıl 2023, Cilt: 4 Sayı: 3, 113 - 122, 27.09.2023

Çağla Amutkan Çiçek

https://doi.org/10.47482/acmr.1339401

Öz

Background:The Social Insurance Institution of Turkey reported that in 2021, there were approximately 12 million patients with diabetes under universal health insurance. and the expenditure was incurred for the treatment of complications was TL 2.6 billion.Although previous studies have analyzed the cost of diabetic foot ulcers, no study from Turkey has yet compared the costs of diabetic hand ulcers and foot ulcers and analyzed the relationship between the cost and demographic characteristics of patients.
Methods:From January 2022 to June 2022, the data of 49 patients with diabetic hand ulcers and 44 patients with diabetic foot ulcers were analyzed retrospectively according to demographic datas and costs.Correlations were analyzed using cross tables, chi-square statistics, and partial correlation analysis, and groups were compared using t-test for independent groups and covariance analysis.
Results:The calculated average cost of patients who were followed up and treated for diabetic hand and foot ulcers was 257.01 USD and 462.54 USD, respectively. There was no statistically significant difference between the patients with diabetic hand and diabetic foot ulcers in terms of mean age, length of hospital stay, or HBA1C and CRP levels at admission. The mean cost of the diabetic hand was lower than that of the diabetic foot, and this difference was statistically significant.
Conclusion:Although diabetic hand infections are less costly and cause fewer major amputations, it is a clinical condition that should be given at least as much attention as diabetic foot ulcer due to its atypical localized onset and the reproductive potential of different microorganisms.

Anahtar Kelimeler

Key words: Cost analyze, diabetic foot ulcer, diabetic hand ulcer, tropical hand infection

Kaynakça

• Morsanutto A, Berto P, Lopatriello S, Gelisio R, Voinovich D, Cippo PP, Mantovani LG. Major complications have an impact on total annual medical cost of diabetes: results of a database analysis. J Diabetes Complications. 2006;20(3):163-9.
• American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-46.
• World Health Organization. Global report on diabetes. Geneva. 2016. Available at https://www.who.int/ publications/i/ item/9789241565257 Accessed September 26, 2022
• International Diabetes Federation. IDF Diabetes Atlas 9th ed. Brussels, Belgium. 2019. Available at https://diabetesatlas.org/atlas/ninthedition/ Accessed September 27, 2022
• World Health Organization. Global health expenditure database. Geneva. 2019. Available at https://apps.who.int/nha/database Accessed September 27, 2022
• Li R, Bilik D, Brown MB, Zhang P, Ettner SL, Ackermann RT, et al. Medical costs associated with type 2 diabetes complications and comorbidities. Am J Manag Care. 2013;19(5):421-30.
• Papanas N, Maltezos E. The diabetic hand: a forgotten complication? J Diabetes Complications. 2010;24(3):154-62.
• Driver VR, Fabbi M, Lavery LA, Gibbons G. The costs of diabetic foot: the economic case for the limb salvage team. J Vasc Surg. 2010;52(3 Suppl):17-22
• Gençalioğlu E. Karadeniz Teknik Üniversitesi Farabi Hastanesi’nde tedavi gören diyabetik ayağı olan hastaların maliyet analizi [dissertation]. Avrasya Üniversitesi Sağlık Bilimleri Enstitüsü; 2014.
• Gönen MS, Çakır M, Gönülalan G, Öztürk M, İpekçi SH, Köşker A. et al. The problems and cost-effectiveness analysis of diabetic foot ınfections. Turk Jem.2012;16:10-13.
• Jennings AM, Milner PC, Ward JD. Hand abnormalities are associated with the complications of diabetes in Type 2 diabetes. Diabet Med.1989; 6: 43-47.
• Abbas ZG, Lutale J, Gill GV, Archibald LK. Tropical diabetic hand syndrome: risk factors in an adult diabetes population. Int J Infect Dis. 2001; 5: 19-23.
• Gill GV, Famuyiwa OO, Rolfe M, Archibald LK. Tropical diabetic hand syndrome. Lancet 1998; 351: 113-114.
• Lekic N, Rosenberg AE, Askari M. Mycobacterium longobardum Infection in the Hand. J Hand Surg Am. 2018;43(5):491.e1-491.e4.
• Houshian S, Seyedipour S, Wedderkopp N. Epidemiology of bacterial hand infections. Int J Infect Dis.2006; 10: 315-319.
• Bajaj S, Bajaj AK Tropical diabetic hand syndrome―Indian experience. J Assoc Physicians India. 1999; 47: 1118-1119.
• Bahar Moni AS, Hoque M, Mollah RA, Ivy RS, Mujib I. Diabetic Hand Infection: An Emerging Challenge. J Hand Surg Asian Pac Vol. 2019;24(3):317-322.
• Akanji AO, Famuyiwa OO, Adetuyibi A. Factors influencing the outcome of treatment of foot lesions in Nigerian patients with diabetes mellitus. Q J Med. 1989;73(271):1005-1014.
• Jalil A, Barlaan PI, Fung BK, Ip JW. Hand infection in diabetic patients. Hand Surg. 2011;16(3):307-312.
• Mann RJ, Peacock JM. Hand infections in patients with diabetes mellitus. J Trauma. 1977;17(5):376-380.
• Francel TJ, Marshall KA, Savage RC. Hand infections in the diabetic and the diabetic renal transplant recipient. Ann Plast Surg. 1990;24(4):304-309.
• Raveendran S, Naik D, Raj Pallapati SC, Prakash JJ, Thomas BP, Thomas N. The clinical and microbiological profile of the diabetic hand: A retrospective study from South India. Indian J Endocrinol Metab. 2016;20(5):619-624.
• Al Benwan K, Al Mulla A, Rotimi VO. A study of the microbiology of diabetic foot infections in a teaching hospital in Kuwait. J Infect Public Health. 2012;5(1):1-8.
• Saltoglu N, Ergonul O, Tulek N, Yemisen M, Kadanali A, Karagoz G et al. Influence of multidrug resistant organisms on the outcome of diabetic foot infection. Int J Infect Dis. 2018;70:10-14.