Maximilian O. Joret|Kareem Osman|Anastasia Dean|Colin Cao|Bert van der Werf|Venu Bhamidipaty
Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic foot disease
Auckland City Hospital|Auckland City Hospital|Auckland City Hospital|Auckland District Health Board|University of Auckland|Auckland City Hospital
diabetic foot disease poses significant rising financial burden health care systems worldwide study investigated effect new multidisciplinary diabetic foot clinic mddfc large tertiary hospital patient outcomes treatment costpatients records retrospectively reviewed identify patients managed new mddfc july 2014 july 2017 wound episodethe period initial presentation achievement final wound outcomewas identified relevant inpatient outpatient costs extracted using fully absorbed activitybased costing methodology risk factor treatment outcome costing data cohort compared group patients diabetic foot wounds managed hospital advent mddfc using generalized linear mixed modelthe mddfc premddfc cohorts included 73 patients 80 wound episodes 225 patients 265 wound episodes respectively compared premddfc cohort mddfc group fewer inpatient admissions 156 vs 264 p 001 mddfc patients lower major amputation rate 38 vs 275 p 001 lower mortality rate 75 vs 192 p 05 higher rate minor amputation 538 vs 317 p 01 statistically significant difference noted rate excisional dbridement skin graft open endovascular revascularization mddfc cohort median total cost inpatient cost outpatient cost per wound episode new zealand dollars nzd 22407465 us dollars usd 1725374 nzd 2163893 usd 1666197 nzd 691915 usd 53277 respectively mddfc premddfc wound episode total cost ratio 07586 p 001this study first compare cost treatment outcomes diabetic foot patients treated large tertiary hospital introduction mddfc results show mddfc improves patient outcomes reduces cost treatment mddfcs adopted standard care diabetic foot patients