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

The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.

Burden of Diabetic Foot Ulcers for Medicare and Private Insurers

Open access
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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Crossref · 10.2337/dc13-2176

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Metadata

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
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
Licence
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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