Economic Evaluations of Diabetic Foot Care

The economic impact of diabetic foot complications encompasses both direct healthcare expenditures and indirect costs such as productivity losses and reduced quality of life. Direct costs include hospital admissions, surgical interventions, wound-care supplies and outpatient services, while indirect costs arise from work absenteeism, long-term disability and informal caregiving. Economic evaluations in this domain employ methodologies ranging from micro-costing studies that itemise resource use to model-based cost-utility analyses that assess interventions over multiple time horizons. Key drivers of cost include the frequency and duration of hospital stays, rates of lower-limb amputation and the adoption of advanced therapies or preventive strategies. With diabetes prevalence rising globally, diabetic foot care is becoming a substantial fiscal challenge for health systems. Variations in care pathways and unit costs across regions further emphasise the need for context-specific evaluations. Preventive measures such as temperature monitoring, structured foot-care programmes and offloading devices have shown potential for cost savings by reducing ulcer recurrence and amputation rates. Economic evidence thus underpins policy decisions aimed at optimising resource allocation, improving patient outcomes and ensuring sustainable service delivery.

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Economic Evaluations of Diabetic Foot Care publication trend

The graph below shows the total number of articles in economic evaluations of diabetic foot care across all publications each year (not limited to Nature Index journals).

Technical terms

Direct costs: Expenditures for medical services, including hospital admissions, treatments and supplies.

Indirect costs: Economic losses from factors such as reduced productivity, absenteeism and informal care.

Quality-adjusted life year (QALY): A measure combining life expectancy and quality of life into a single index for health economic assessment.

Incremental cost-effectiveness ratio (ICER): The additional cost per additional unit of health outcome, often expressed per QALY gained.

Micro-costing: A detailed costing method that quantifies and values each component of resource use in an intervention.

References

1. Current knowledge of morbidities and direct costs related to diabetic foot disorders: a literature review. Frontiers in Endocrinology (2024).
2. Burden of Infected Diabetic Foot Ulcers on Hospital Admissions and Costs in a Third-Level Center. Diabetology (2024).