Cost and resource utilization for prevention and treatment of foot lesions in a diabetic foot clinic in Belgium.

This prospective observational study was carried out to assess the annual preventive and curative treatment costs for diabetic foot problems. Measures of resource use over the 1-year study period were taken for 151 patients whose lesions covered the entire Wagner classification. Treatment was provided under the current protocols of a multidisciplinary team. The 1993 market prices for health services were used to convert units of health service utilization to expenditures by the social insurance system and the patients. The severity of the foot problems determined the medical cost. Preventive care (47 cases), represented an average cost per case of US$ 880 (1US$ 1993=BEF 30.65). Curative care (120 cases), including diagnostic tests, wound dressings, antibiotic therapy, revascularization and off loading techniques resulted in a mean cost of US$ 5227 per ulcer. Care for the 16 most severe wounds and amputations involved hospitalization and surgery at a mean cost per ulcer of US$ 31716. The most important cost contributers were hospitalizations (72%), drugs (11%) and diagnostic examinations (4%). Preventive treatment for diabetic foot problems can represent a significant saving for the social insurance system as well as for the patients.