The economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers

• Published in: Journal of the American Podiatric Medical Association Vol. 101; no. 2; p. 93
• Main Authors: Carls, Ginger S, Gibson, Teresa B, Driver, Vickie R, Wrobel, James S, Garoufalis, Matthew G, Defrancis, Roy R, Wang, Shaohung, Bagalman, J Erin, Christina, James R
• Format: Journal Article
• Language: English
• Published: United States 01.03.2011
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cost-Benefit Analysis; Diabetic Foot - economics; Diabetic Foot - therapy; Female; Humans; Male; Medicare - economics; Middle Aged; Physicians - economics; Podiatry - economics; Podiatry - manpower; Retrospective Studies; United States; Young Adult; United States
• ISSN: 1930-8264
• DOI: 10.7547/1010093

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. We analyzed the economic value among commercially insured patients and Medicare-eligible patients with employer-sponsored supplemental medical benefits using the MarketScan 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. 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. These findings suggest that podiatric medical care can reduce the disease and economic burdens of diabetes.