Skip to main content
Top
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Economic burden of illness associated with diabetic foot ulcers in Canada

Authors: Robert B Hopkins, Natasha Burke, John Harlock, Jathishinie Jegathisawaran, Ron Goeree

Published in: BMC Health Services Research | Issue 1/2015

Login to get access

Abstract

Background

The primary objective was to estimate the national burden of illness in Canada for diabetic foot ulcer (DFU) for 2011. Secondary objectives included estimating the national incidence and prevalence of DFU, and the 3-year average cost for DFU incident cases.

Methods

Analyses were conducted using four national databases for the period April 1, 2006 to March 31, 2011, with cases being identified by ICD-10 CA codes. Resource utilization and costs, expressed in 2011 Canadian dollars, were estimated for DFU-related hospitalizations, emergency care (ER), same day surgeries, home care, long term care, physician visits and caregiver time losses.

Results

In Canada in the year 2011, DFU was associated with 16,883 hospital admissions (327,140 days), 31,095 ER or clinic visits, 41,367 rehabilitation clinic visits, and 26,493 interventions, including 6,036 amputations and 5,796 surgical debridements. This acute institution care represented $320.5 M, and with an additional $125.4 M for home care and $63.1 M for long term care, the annual cost associated with DFU-related care was $547.0 M, or $21,371 annual cost per prevalent case. In 2011, the national prevalence of DFU was 25,597 cases (75.1 per 100,000 population), consisting of 16,161 men (63.1%) and 9,436 women (36.9%), and an estimated 14,449 incident cases. For an incident case of DFU, the average 3-year cumulative cost was $52,360.

Conclusion

The annual burden for DFU cases that have at least one admission or ER/clinic visit over a 5 year period is higher than previously reported.
Appendix
Available only for authorised users
Literature
1.
go back to reference Lipscombe LL, Hux JE. Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based study. Lancet. 2007;369(9563):750–6.CrossRefPubMed Lipscombe LL, Hux JE. Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based study. Lancet. 2007;369(9563):750–6.CrossRefPubMed
2.
go back to reference Canadian Association of Wound Care. Statistics. 2013. Canadian Association of Wound Care. Statistics. 2013.
3.
go back to reference Goeree R, Lim ME, Hopkins R, Blackhouse G, Tarride JE, Xie F, et al. Prevalence, total and excess costs of diabetes and related complications in Ontario, Canada. Can J Diabetes. 2009;33(1):35–45.CrossRef Goeree R, Lim ME, Hopkins R, Blackhouse G, Tarride JE, Xie F, et al. Prevalence, total and excess costs of diabetes and related complications in Ontario, Canada. Can J Diabetes. 2009;33(1):35–45.CrossRef
4.
go back to reference American Diabetes Association. Consensus development conference on diabetic foot wound care. Diabetes Care. 1999;22(8):1354–60.CrossRef American Diabetes Association. Consensus development conference on diabetic foot wound care. Diabetes Care. 1999;22(8):1354–60.CrossRef
5.
go back to reference Shannon RJ. A cost-utility evaluation of best practice implementation of leg and foot ulcer care in the Ontario community. Wound Care Canada. 2007;5 Suppl 1:S53–6. Shannon RJ. A cost-utility evaluation of best practice implementation of leg and foot ulcer care in the Ontario community. Wound Care Canada. 2007;5 Suppl 1:S53–6.
6.
go back to reference Ray JA, Valentine WJ, Secnik K, Oglesby AK, Cordony A, Gordois A, et al. Review of the cost of diabetes complications in Australia, Canada, France, Germany, Italy and Spain. Curr Med Res Opin. 2005;21(10):1617–29.CrossRefPubMed Ray JA, Valentine WJ, Secnik K, Oglesby AK, Cordony A, Gordois A, et al. Review of the cost of diabetes complications in Australia, Canada, France, Germany, Italy and Spain. Curr Med Res Opin. 2005;21(10):1617–29.CrossRefPubMed
7.
8.
go back to reference Canadian Institute for Health Information. Data Quality Documentation for External Users: Discharge Abstract Database (DAD), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2011. Canadian Institute for Health Information. Data Quality Documentation for External Users: Discharge Abstract Database (DAD), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2011.
9.
go back to reference Canadian Institute for Health Information. Data Quality Documentation for External Users: National Ambulatory Care Reporting System (NACRS), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2012. Canadian Institute for Health Information. Data Quality Documentation for External Users: National Ambulatory Care Reporting System (NACRS), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2012.
10.
go back to reference Canadian Institute for Health Information. Data Quality Documentation for External Users: Home Care Reporitng System (HCRS), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2012. Canadian Institute for Health Information. Data Quality Documentation for External Users: Home Care Reporitng System (HCRS), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2012.
11.
go back to reference Canadian Institute for Health Information. Data Quality Documentation for External Users: Continuing Care Reporting System (CCRS), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2012. Canadian Institute for Health Information. Data Quality Documentation for External Users: Continuing Care Reporting System (CCRS), 2010–2011. Ottawa, Ontario, Canada: CIHI; 2012.
12.
go back to reference Statistics Canada. Estimates of Population, By Age Group And Sex For July 1, Canada, Provinces And Territories, Annual. Table 051–0001. 2012. Statistics Canada. Estimates of Population, By Age Group And Sex For July 1, Canada, Provinces And Territories, Annual. Table 051–0001. 2012.
13.
go back to reference Poss J, Murphy KM, Woodbury MG, Orsted H, Stevenson K, Williams G, et al. Development of the interRAI Pressure Ulcer Risk Scale (PURS) for use in long-term care and home care settings. BMC Geriatr. 2010;10:67.CrossRefPubMedPubMedCentral Poss J, Murphy KM, Woodbury MG, Orsted H, Stevenson K, Williams G, et al. Development of the interRAI Pressure Ulcer Risk Scale (PURS) for use in long-term care and home care settings. BMC Geriatr. 2010;10:67.CrossRefPubMedPubMedCentral
14.
go back to reference Health Quality Ontario. Hyperbaric Oxygen Treatment for Diabetic Ulcers. Publications and OHTAC Recommendations: Work in Progress. Ontario Ministry of Health and Long Term Care. 2014. Health Quality Ontario. Hyperbaric Oxygen Treatment for Diabetic Ulcers. Publications and OHTAC Recommendations: Work in Progress. Ontario Ministry of Health and Long Term Care. 2014.
15.
go back to reference Canadian Institute for Health Information. Health Indicators. Ottawa, ON: CIHI; 2012. Canadian Institute for Health Information. Health Indicators. Ottawa, ON: CIHI; 2012.
16.
go back to reference Trubiani G, Pham B, Stern A, Carcone S, Rosen L, Krahn M. Specialized Multidisciplinary Community-Based Care for Chronic Wounds: A Field Evaluation. Toronto Health Economics and Technology Assessment Collaborative (THETA). 2011. Trubiani G, Pham B, Stern A, Carcone S, Rosen L, Krahn M. Specialized Multidisciplinary Community-Based Care for Chronic Wounds: A Field Evaluation. Toronto Health Economics and Technology Assessment Collaborative (THETA). 2011.
17.
go back to reference Alvarez P, Ward A, Chow W, Vo L, Martin S. Direct Medical costs of Diabetic Complications in the United States. Value in Health. 2013. Conference: ISPOR 18th Annual International Meeting New Orleans, LA United States. Conference Start: 20130518 Conference End: 20130522. Conference Publication:(var.pagings):A188. Alvarez P, Ward A, Chow W, Vo L, Martin S. Direct Medical costs of Diabetic Complications in the United States. Value in Health. 2013. Conference: ISPOR 18th Annual International Meeting New Orleans, LA United States. Conference Start: 20130518 Conference End: 20130522. Conference Publication:(var.pagings):A188.
18.
go back to reference Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons N. Medical, Drug, and Work-Loss Costs of Diabetic Foot Ulcers. Value in Health. 2013. Conference: ISPOR 18th Annual International Meeting New Orleans, LA United States. Conference Start: 20130518 Conference End: 20130522. Conference Publication:(var.pagings):A12. Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons N. Medical, Drug, and Work-Loss Costs of Diabetic Foot Ulcers. Value in Health. 2013. Conference: ISPOR 18th Annual International Meeting New Orleans, LA United States. Conference Start: 20130518 Conference End: 20130522. Conference Publication:(var.pagings):A12.
19.
go back to reference Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005;366(9498):1719–24.CrossRefPubMed Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005;366(9498):1719–24.CrossRefPubMed
20.
go back to reference O’Reilly D, Hopkins R, Blackhouse G, Clarke P, Hux J, Tarride JE, et al. Long-term cost-utility analysis of a multidisciplinary primary care diabetes management program in Ontario. Can J Diabetes. 2007;31(3):205–14.CrossRef O’Reilly D, Hopkins R, Blackhouse G, Clarke P, Hux J, Tarride JE, et al. Long-term cost-utility analysis of a multidisciplinary primary care diabetes management program in Ontario. Can J Diabetes. 2007;31(3):205–14.CrossRef
21.
go back to reference The Council of the Federation. From Innovation to Action: The First Report of the Health Care Innovation Working Group. The Council of the Federation. 2012. The Council of the Federation. From Innovation to Action: The First Report of the Health Care Innovation Working Group. The Council of the Federation. 2012.
Metadata
Title
Economic burden of illness associated with diabetic foot ulcers in Canada
Authors
Robert B Hopkins
Natasha Burke
John Harlock
Jathishinie Jegathisawaran
Ron Goeree
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0687-5

Other articles of this Issue 1/2015

BMC Health Services Research 1/2015 Go to the issue