Burden of Diabetic Foot Ulcers for Medicare and Private Insurers

Rice, J. Bradford; Desai, Urvi; Cummings, Alice Kate G.; Birnbaum, Howard G.; Skornicki, Michelle; Parsons, Nathan B.

doi:10.2337/dc13-2176

Cited by 624Diabetic Foot Ulcer Assessment and ManagementHealth Systems, Economic Evaluations, Quality of LifeSkin Diseases and Diabetes

Burden of Diabetic Foot Ulcers for Medicare and Private Insurers

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Rice, J. Bradford, Desai, Urvi, Cummings, Alice Kate G., Birnbaum, Howard G., Skornicki, Michelle, Parsons, Nathan B.·2014·Diabetes Care

DOI 10.2337/dc13-2176

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Abstract

OBJECTIVE: To estimate the annual, per-patient incremental burden of diabetic foot ulcers (DFUs). RESEARCH DESIGN AND METHODS: DFU patients and non-DFU patients with diabetes (controls) were selected using two deidentified databases: ages 65+ years from a 5% random sample of Medicare beneficiaries (Standard Analytical Files, January 2007–December 2010) and ages 18–64 years from a privately insured population (OptumInsight, January 2007–September 2011). Demographics, comorbidities, resource use, and costs from the payer perspective incurred during the 12 months prior to a DFU episode were identified. DFU patients were matched to controls with similar pre-DFU characteristics using a propensity score methodology. Per-patient incremental clinical outcomes (e.g., amputation and medical resource utilization) and health care costs (2012 U.S. dollars) during the 12-month follow-up period were measured among the matched cohorts. RESULTS: Data for 27,878 matched pairs of Medicare and 4,536 matched pairs of privately insured patients were analyzed. During the 12-month follow-up period, DFU patients had more days hospitalized (+138.2% Medicare, +173.5% private), days requiring home health care (+85.4% Medicare, +230.0% private), emergency department visits (+40.6% Medicare, +109.0% private), and outpatient/physician office visits (+35.1% Medicare, +42.5% private) than matched controls. Among matched patients, 3.8% of Medicare and 5.0% of privately insured DFU patients received lower limb amputations. Increased utilization resulted in DFU patients having $11,710 in incremental annual health care costs for Medicare, and $16,883 for private insurance, compared with matched controls. Privately insured matched DFU patients incurred excess work-loss costs of $3,259. CONCLUSIONS: These findings document that DFU imposes substantial burden on public and private payers, ranging from $9–13 billion in addition to the costs associated with diabetes itself.

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The SurroGait Rx device has been successful for pressure-offloading alerts to prevent diabetic foot ulcers.
“This device has also been successful for pressure-offloading alerts to prevent diabetic foot ulcers, which cost the US$81.7 billion in 2012 [104,105].”
From Wearables and the Medical Revolution (2018) · cites this paper as [104]

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Medical, Drug, And Work-Loss Costs Of Diabetic Foot Ulcers
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Burden of Diabetic Foot Ulcers for Medicare and Private Insurers. Diabetes Care 2014;37:651–658
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Comparison of costs related to health services in two groups of patients with diabetic foot ulcer and patients without this complication: a matched cohort study
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Diabetic Foot Ulcer in Malaysia: Consensus on Treatment Patterns, Health Care Utilization and Cost
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Authors: Rice, J. B., Desai, U., Cummings, A. K. G., Birnbaum, H. G., Skornicki, M., & Parsons, N. B.
Affiliations: Analysis Group (United States) (US)
Organogenesis (United States) (US)
Corresponding author: Rice, J. Bradford
ORCID: Rice, J. Bradford
Desai, Urvi
Skornicki, Michelle
Parsons, Nathan B.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2014-02-11
Volume: 37
Issue: 3
Pages: 651-658
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc13-2176
OpenAlex: W2117137845
Cited by: 624
References: 19
Citations by year: 2026: 51 · 2025: 71 · 2024: 55 · 2023: 50 · 2022: 65 · 2021: 55 · 2020: 58 · 2019: 49 · 2018: 57 · 2017: 48 · 2016: 37 · 2015: 23 · 2014: 4
FWCI: 16.81
Type: journal article
Language: en
Update notices: correction (2014-09-01)
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/3.0/ (vor, 2755 d)
Locations: Diabetes Care (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
Keywords: diabetic foot ulcer, health care costs, health care utilization, lower limb amputation, Medicare, private insurance, work loss costs, hospitalization, home health care, emergency department visits, diabetes complications
MeSH terms: Adolescent, Adult, Amputation, Surgical, Female, Medicare, Health Resources, Humans, Insurance Carriers, Male, Middle Aged, United States, Comorbidity, Health Care Costs, Private Sector, Cost of Illness, Diabetic Foot, Young Adult, Propensity Score

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