Health Costs and Quality of Life Among Diabetic Foot Ulcer Patients in South India: A Cross-Sectional Study

The financial burden of managing diabetic foot ulcers (DFUs) can lead to catastrophic health expenditure (CHE) and financial hardship, ultimately impacting the quality of life (QoL) of patients. The relationship between healthcare costs and health-related quality of life (HRQoL) is critical for understanding the broader implications on patients' physical, psychological, and social well-being.

A cross-sectional study was conducted among DFU patients selected using convenient sampling. A semi-structured questionnaire was used to assess patients' socio-demographic and clinical characteristics. HRQoL was assessed using the 36-Item Short Form Survey (SF-36).

The sample population was 173 patients, including 125 (72.3%) male and 48 (27.7%) female patients. The mean age was 57.80 ± 10.51 years. The total out-of-pocket expenditure (OOPE) amounted to Rs. 89317.51 ± 150378.81 ($1134.33 ± 1909.81). Around 81 (46.8%) patients were experiencing CHE. The socioeconomic status, duration of diabetes, and severity of wounds significantly influence the likelihood of experiencing CHE (p < 0.05). Lower QoL scores were obtained in the domain of physical functioning (37.23 ± 23.26), role physical (17.34 ± 30.55), and role emotional (18.11 ± 32.64). Gender, occupational status, comorbidities, wound duration, Wagner's grading of ulcers, and CHE significantly impact various domains of HRQoL (p < 0.05).

The substantial healthcare costs of managing DFUs can result in financial strain, negatively influencing patients' QoL. Therefore, it is essential to focus on both the financial implications of diabetes management and the enhancement of patients' QoL to achieve better health outcomes.