The Economic Value of Specialized Lower-Extremity Medical Care by Podiatric Physicians in the Treatment of Diabetic Foot Ulcers
The Economic Value of Specialized Lower-Extremity Medical Care by Podiatric Physicians in the Treatment of Diabetic Foot Ulcers
复制标题
DOI：
10.7547/1010093
复制
发表时间：
2011-03-01
影响因子：
0.7
通讯作者：
Christina, James R.
中科院分区：
文献类型：
--
作者：
Cans, Ginger S.;Gibson, Teresa B.;Christina, James R.
背景：我们试图通过评估在足部溃疡发病前一年接受和没有接受足科医生护理的糖尿病足部溃疡患者的成本结果，来检验由足部医生提供的专门的下肢医疗在糖尿病足部溃疡治疗中的经济价值。方法：我们使用Market Scan数据库分析了商业保险患者和符合医疗保险条件的患者的经济价值，这些患者拥有雇主赞助的补充医疗福利。分析由两部分组成。在第一部分中，我们使用倾向分数匹配和回归技术检查了与足科医生的护理相关的每个患者的成本或节省；在第二部分中，我们将成本或节省外推到人群中。结果：匹配和回归调整的结果表明，在两年的随访中，去看足科医生的患者在商业计划中的成本降低了13,474美元，而在医疗保险计划中的成本降低了3,624美元(P<；两者均为0.01)。研究发现，糖尿病足溃疡高危患者的比例增加了1%，雇主赞助的计划的净现值为120万至1770万美元，医疗保险计划的净现值为100万至1270万美元。结论：这些发现表明，足科医疗可以减轻糖尿病的疾病和经济负担。(《足科医学杂志》101(2)：93-115,2011)
Background: We sought to examine the economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers by evaluating cost outcomes for patients with diabetic foot ulcer who did and did not receive care from a podiatric physician in the year before the onset of a foot ulcer.Methods: We analyzed the economic value among commercially insured patients and Medicare-eligible patients with employer-sponsored supplemental medical benefits using the Market Scan Databases. The analysis consisted of two parts. In part I, we examined cost or savings per patient associated with care by podiatric physicians using propensity score matching and regression techniques; in part II, we extrapolated cost or savings to populations.Results: Matched and regression-adjusted results indicated that patients who visited a podiatric physician had $13,474 lower costs in commercial plans and $3,624 lower costs in Medicare plans during 2-year follow-up (P < .01 for both). A positive net present value of increasing the share of patients at risk for diabetic foot ulcer by 1% was found, with a range of $1.2 to $17.7 million for employer-sponsored plans and $1.0 to $12.7 million for Medicare plans.Conclusions: These findings suggest that podiatric medical care can reduce the disease and economic burdens of diabetes. (J Am Podiatr Med Assoc 101(2): 93-115, 2011)