| 1. |
- Ragnarson Tennvall, Gunnel, et al.
(författare)
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Health-economic consequences of diabetic foot lesions.
- 2004
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Ingår i: Clinical Infectious Diseases. - 1537-6591. ; 39 Suppl 2, s. 9-132
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedDiabetic foot complications result in huge costs for both society and the individual patients. Few reports on the health-economic consequences of diabetic foot infections have been published. In studies considering a wide societal perspective, costs of antibiotics were relatively low, whereas total costs for topical treatment were high relative to the total costs of foot infections. Total direct costs for healing of infected ulcers not requiring amputation are similar to$17,500 (in 1998 US dollars), whereas the costs for lower-extremity amputations aresimilar to$30,000-$33,500 depending on the level of amputation. Prevention of foot ulcers and amputations by various methods, including patient education, proper footwear, and foot care, in patients at risk is cost effective or even cost saving. Awareness of the potential influence of reimbursement systems on prevention, management, and outcomes of diabetic foot lesions has increased. Despite methodological obstacles, modeling studies are needed in future health-economic evaluations to determine the cost effectiveness of various strategies.
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| 2. |
- Ragnarson Tennvall, Gunnel
(författare)
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The Diabetic Foot. Costs, health economic aspects, prevention and quality of life.
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims were to investigate the economic consequences of foot complications in diabetic patients, to measure the influence of diabetic foot complications on health-related quality of life (HRQL), and to analyse the cost-effectiveness of interventions to prevent foot ulcers and lower extremity amputations (LEA). The economic consequences of foot ulcers and LEA are large both in a short and a longer perspective. Seventy-six percent of the total short term costs for LEA occurred after amputations had been performed and before complete healing had been achieved. The major long-term costs for the 3 years following healing were related to increased home care and social service, especially for patients who had undergone LEA. The most important determinants of the cost of an ulcer with deep foot infection were wound healing duration and repeated surgery. Costs of inpatient care and topical treatment represent a substantial part of the total costs for both primary healing and healing with minor or major amputation. The frequency of dressing changes and velocity of healing together with costs of material, staff and transportation are important factors for the total topical treatment costs. The Swedish Inpatient Registry is valid regarding completeness of registered discharges for patients who have been treated for foot ulcers, but the database is less valid with reference to reported diagnoses. Cost analyses of diabetic foot complications will be seriously underestimated when based exclusively on primary diagnosis from the database. Patients with current foot ulcers value their HRQL significantly lower than primary healed patients. HRQL is reduced in patients who have undergone major amputations. An intensified prevention strategy including patient education, foot care and footwear is cost-effective or cost saving if the risk for foot ulcers and lower extremity amputations could be reduced by 25%. The strategy would be cost-effective or cost saving in all patients with diabetes, except in those without specific risk factors for development of these complications.
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| 3. |
- Ragnarson Tennvall, Gunnel, et al.
(författare)
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Venösa bensår kan behandlas både bättre och billigare. Beräkning av årliga kostnader baserad på en enkätstudie
- 2004
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Ingår i: Läkartidningen. - 0023-7205. ; 101:17, s. 10-1512
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Tidskriftsartikel (refereegranskat)abstract
- Weekly resource use data for local wound treatment was collected from a clinical survey (138 patients). Annual costs were calculated from the weekly resource usage multiplied by unit costs and published epidemiological prevalence data for Sweden. The average weekly cost was 101 euro, though it differed depending by ulcer size. The total direct annual cost of venous leg ulcers in Sweden could be estimated at 73 million euro (2002 prices, 1 euro = SEK 9.16) based on a point prevalence of 0.3 percent and 45 percent venous ulcers. Treatment of leg ulcers seems to have improved compared with previous reports, resulting in slightly decreased costs. Nevertheless, the costs are still substantial and the management of these patients requires large resources. A more structured management, more careful selection of dressing products and decreased frequency of dressing changes imply further improvements in wound healing and quality of life for patients and decreased costs for the health care system and for society.
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