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

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 diabete...

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Autores principales: Sima, Diana I., Bondor, Cosmina I., Vereşiu, Ioan A., Gâvan, Norina A., Borzan, Cristina M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956777/
https://www.ncbi.nlm.nih.gov/pubmed/33668243
http://dx.doi.org/10.3390/ijerph18052230
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author Sima, Diana I.
Bondor, Cosmina I.
Vereşiu, Ioan A.
Gâvan, Norina A.
Borzan, Cristina M.
author_facet Sima, Diana I.
Bondor, Cosmina I.
Vereşiu, Ioan A.
Gâvan, Norina A.
Borzan, Cristina M.
author_sort Sima, Diana I.
collection PubMed
description 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.
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spelling pubmed-79567772021-03-16 Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania Sima, Diana I. Bondor, Cosmina I. Vereşiu, Ioan A. Gâvan, Norina A. Borzan, Cristina M. Int J Environ Res Public Health Article 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. MDPI 2021-02-24 2021-03 /pmc/articles/PMC7956777/ /pubmed/33668243 http://dx.doi.org/10.3390/ijerph18052230 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sima, Diana I.
Bondor, Cosmina I.
Vereşiu, Ioan A.
Gâvan, Norina A.
Borzan, Cristina M.
Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania
title Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania
title_full Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania
title_fullStr Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania
title_full_unstemmed Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania
title_short Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania
title_sort hospitalization costs of lower limb ulcerations and amputations in patients with diabetes in romania
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956777/
https://www.ncbi.nlm.nih.gov/pubmed/33668243
http://dx.doi.org/10.3390/ijerph18052230
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