TOPICAL TREATMENT OF DIABETIC FOOT ULCERS - AN ECONOMIC-ANALYSIS OF TREATMENT ALTERNATIVES AND STRATEGIES

In a prospective study, 314 patients with diabetic foot ulcers were fo llowed and 40 patients died before healing occurred. In those patients who healed, a retrospective economic analysis of the costs for topica l treatment was performed. The aim of the study was to analyse the cos ts and discuss how different treatment strategies influence total cost s. Data collected for each patient were total time to healing, treatme nt time for each type of dressing, and the frequency of dressing chang es. Material costs for the dressings, labour, and travelling costs wer e calculated separately. A formula for simulation of economic conseque nces of different treatment strategies including the introduction of n ew strategies was designed. The cost for topical treatment was strongl y related to the severity of the ulcer and wound healing time. The ave rage weekly cost per patient for topical treatment varied between poun d 40.3 and pound 385. The dominating costs for topical treatment were expenses for staff and transportation. The most important factor to re duce costs is the frequency of dressing changes. The study emphasizes the need for prospective comparative studies of cost effectiveness in topical treatment strategies.