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

Author

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  • Diana I. Sima

    (Department of Diabetes and Metabolic Diseases, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
    Department of Public Health, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400083 Cluj Napoca, Romania)

  • Cosmina I. Bondor

    (Department of Medical Informatics and Biostatistics, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400349 Cluj Napoca, Romania)

  • Ioan A. Vereşiu

    (Department of Diabetes and Metabolic Diseases, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
    Podiatry Association, 400064 Cluj-Napoca, Romania)

  • Norina A. Gâvan

    (Podiatry Association, 400064 Cluj-Napoca, Romania)

  • Cristina M. Borzan

    (Department of Public Health, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400083 Cluj Napoca, Romania)

Abstract

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.

Suggested Citation

  • Diana I. Sima & Cosmina I. Bondor & Ioan A. Vereşiu & Norina A. Gâvan & Cristina M. Borzan, 2021. "Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania," IJERPH, MDPI, vol. 18(5), pages 1-11, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2230-:d:504985
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    References listed on IDEAS

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    1. Claudiu Morgovan & Smaranda Adina Cosma & Madalina Valeanu & Anca Maria Juncan & Luca Liviu Rus & Felicia Gabriela Gligor & Anca Butuca & Delia Mirela Tit & Simona Bungau & Steliana Ghibu, 2020. "An Exploratory Research of 18 Years on the Economic Burden of Diabetes for the Romanian National Health Insurance System," IJERPH, MDPI, vol. 17(12), pages 1-16, June.
    2. Cristiana M. Toscano & Tatiana H. Sugita & Michelle Q. M. Rosa & Hermelinda C. Pedrosa & Roger Dos S. Rosa & Luciana R. Bahia, 2018. "Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study," IJERPH, MDPI, vol. 15(1), pages 1-13, January.
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    Cited by:

    1. Bogdan Stancu & Tamás Ilyés & Marius Farcas & Horațiu Flaviu Coman & Bogdan Augustin Chiș & Octavian Aurel Andercou, 2022. "Diabetic Foot Complications: A Retrospective Cohort Study," IJERPH, MDPI, vol. 20(1), pages 1-9, December.
    2. Cornelia Bala & Adriana Rusu & Dana Ciobanu & Gabriela Roman, 2022. "Length of Hospital Stay, Hospitalization Costs, and Their Drivers in Adults with Diabetes in the Romanian Public Hospital System," IJERPH, MDPI, vol. 19(16), pages 1-13, August.
    3. Horaţiu Coman & Bogdan Stancu & Norina A. Gâvan & Frank L. Bowling & Laura Podariu & Cosmina I. Bondor & Gabriela Radulian, 2022. "Diabetes-Related Lower Extremity Amputations in Romania: Patterns and Changes between 2015 and 2019," IJERPH, MDPI, vol. 20(1), pages 1-13, December.
    4. Mengen Chen & Fanxin Kong & Bin Su & Xuexuan Wei & Jingyu Yang, 2022. "Factors Influencing Hospitalization Cost for Diabetic Patients in Traditional Chinese Medicine Hospitals in Qingyang City, China," IJERPH, MDPI, vol. 19(21), pages 1-10, October.

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