Universidad Peruana Cayetano Heredia

The cost of illness attributable to diabetic foot and cost-effectiveness of secondary prevention in Peru

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dc.contributor.author Cárdenas García-Santillán, María Kathia
dc.contributor.author Mirelman, Andrew J.
dc.contributor.author Galvin, Cooper J.
dc.contributor.author Lazo Porras, María de los Ángeles
dc.contributor.author Pinto, Miguel
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Gilman, Robert Hugh
dc.date.accessioned 2019-02-06T14:52:14Z
dc.date.available 2019-02-06T14:52:14Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5281
dc.description.abstract BACKGROUND: Diabetes mellitus is a public health challenge worldwide, and roughly 25% of patients with diabetes in developing countries will develop at least one foot ulcer during their lifetime. The gravest outcome of an ulcerated foot is amputation, leading to premature death and larger economic costs. METHODS: This study aimed to estimate the economic costs of diabetic foot in high-risk patients in Peru in 2012 and to model the cost-effectiveness of a year-long preventive strategy for foot ulceration including: sub-optimal care (baseline), standard care as recommended by the International Diabetes Federation, and standard care plus daily self-monitoring of foot temperature. A decision tree model using a population prevalence-based approach was used to calculate the costs and the incremental cost-effectiveness ratio (ICER). Outcome measures were deaths and major amputations, uncertainty was tested with a one-way sensitivity analysis. RESULTS: The direct costs for prevention and management with sub-optimal care for high-risk diabetics is around US$74.5 million dollars in a single year, which decreases to US$71.8 million for standard care and increases to US$96.8 million for standard care plus temperature monitoring. The implementation of a standard care strategy would avert 791 deaths and is cost-saving in comparison to sub-optimal care. For standard care plus temperature monitoring compared to sub-optimal care the ICER rises to US$16,124 per death averted and averts 1,385 deaths. CONCLUSION: Diabetic foot complications are highly costly and largely preventable in Peru. The implementation of a standard care strategy would lead to net savings and avert deaths over a one-year period. More intensive prevention strategies such as incorporating temperature monitoring may also be cost-effective. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Health Services Research
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Treatment Outcome en_US
dc.subject Cost-Benefit Analysis en_US
dc.subject Cost of Illness en_US
dc.subject Ambulatory Care/economics en_US
dc.subject Diabetes Mellitus, Type 2/economics/prevention & control en_US
dc.subject Diabetic Foot/economics/prevention & control en_US
dc.subject Secondary Prevention/economics en_US
dc.title The cost of illness attributable to diabetic foot and cost-effectiveness of secondary prevention in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12913-015-1141-4
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.02
dc.relation.issn 1472-6963


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