THE COST OF TRAINING A DIABETIC PATIENT - EFFECTS ON PREVENTION OF AMPUTATION

Cost of disease is a complex notion : financial cost, psychological co st for those who have cope with a chronic disease. But there is also a nother cost which has not yet sufficiently been taken into account : t he cost of resistance to change. It has largely been shown that patien t education could result in major cost-saving as well as improvement o f quality of life. Why is there such a resistance from health care pro viders, health policy planners for implementation of patients educatio n programes ? These resistances may well be part of the real cost of e fficient control of a disease and like in the case of diabetes, preven tion of acute and chronic complications. Education and training of pat ients has enabled us to decrease markedly lower extremities amputation s : 12 times less above knee amputations, reduction by half of below k nee amputations and a four fold decrease of toe amputations at the Uni versity Hospital of Geneva, Switzerland.