Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania

Diana I. Sima, Cosmina I. Bondor, Ioan A. Vereşiu, Norina A. Gâvan and Cristina M. Borzan
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Diana I. Sima: Department of Diabetes and Metabolic Diseases, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
Cosmina I. Bondor: Department of Medical Informatics and Biostatistics, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400349 Cluj Napoca, Romania
Ioan A. Vereşiu: Department of Diabetes and Metabolic Diseases, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
Norina A. Gâvan: Podiatry Association, 400064 Cluj-Napoca, Romania
Cristina M. Borzan: Department of Public Health, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400083 Cluj Napoca, Romania

IJERPH, 2021, vol. 18, issue 5, 1-11

Abstract: In this retrospective case-control study conducted in Cluj-Napoca, Romania, we assessed the effect of ulcerations/amputations on hospitalization costs of patients with diabetes. Patients with (Group 1) or without (Group 2) ulcerations/amputations (case-control ratio 3:1) admitted to a single diabetes center between 2012–2017 were included. The effects of hospitalization days, age, duration of diabetes, body mass index and glycated hemoglobin (HbA1c) on total costs was explored using a multivariate linear regression analysis, enter model. Overall, 876 patients were included (Group 1: 682, 323 [47.4%] with amputations; Group 2: 194). Median (interquartile range) total expenses in Group 1 were 40% higher compared to Group 2 (€724 [504; 1186] vs €517 [362; 645], p < 0.001). Significant differences were observed between hospitalization costs ( p < 0.001), cost of food ( p < 0.001), medication ( p = 0.044), drugs administered at the emergency room/intensive care unit ( p < 0.001) and other expenses ( p = 0.003). Hospitalization costs represented 80.5% of total expenses in Group 1 and 76.3% in Group 2. In multivariate analysis, hospitalization days influenced significantly the total costs in both groups ( p < 0.001); in Group 2, the effect of HbA1c was also significant ( p = 0.021). Diabetic foot ulcers and subsequent amputations most likely impose a significant economic burden on the Romanian public healthcare system.

Keywords: diabetes mellitus; diabetic neuropathies; diabetic foot; amputation; economics; health care costs; tertiary prevention (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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