Cost-of-Illness Analysis of Diabetic Foot Ulcer: A Prevalence-Based Approach in Southwest of Iran

Diabetic foot ulcer (DFU) is a destructive complication of diabetes that imposes a significant economic burden on patients and the health system. This study was conducted to estimate and influence factors on DFU costs in Ahvaz, Iran.

This study was a cross-sectional study in 2017 among 213 DFU patients referred to Razi Hospital in Ahvaz, Iran. A cost of illness checklist was used to collect information. After calculating the costs, to analyze the effect of variables on the change of costs, regression analysis was used in the generalized linear method with gamma distribution. Also, based on the percentage of changes in cost items in 5 years, the costs of DFU until 2042 were estimated. Data analysis was done using descriptive and analytical tests (gamma regression) in SPSS Version 26 software.

The total costs of each patient in the year were 319,885,040 Rials ($7616.31). Direct medical costs were 280,539,930 Rials ($6679.52) (87.7%), indirect medical costs were 5,670,550 Rials ($135.01) (1.77%), and indirect costs were 3,3674,560 Rials ($801.78) (10.53%). Based on the estimate, annual DFU cost items and total costs will increase by 32 and 258.3 times for each patient in 2042, respectively. Regression analysis showed that type of insurance, presence of infection, hospitalization, degree of wound, duration of wound, family history, and employment status are influential factors in changes in DFU costs.

DFU treatment costs are a substantial financial burden for patients, and these costs are increasing. Controlling the factors affecting the costs during the treatment process of this disease will reduce the financial burden on the patients.