Economic impact of surgical debridements and lower limb amputations in diabetic patients
Keywords:
diabetes, debridement, amputations, costAbstract
Introduction: Type 2 diabetes mellitus (T2DM) constitutes a public health problem. Objectives: Determine the frequency of surgical debridement and lower limb amputations in type 2 diabetic patients and their economic impact. Materials and methods: A descriptive cross-sectional observational study was carried out. The direct medical costs of both surgical debridement and lower limb amputations in diabetic patients at the Hospital de Clínicas, San Lorenzo were estimated during 2019. Results: The total of surgical debridement and lower limb amputations in 2019 represents the 1.9% (314/16,484) of surgical procedures performed at the Hospital de Clínicas. The total amount of expenses is 1,804,185,116 (262,541 USD), of which 172,514,000 (38,857 USD) constitute out-of-pocket expenses and 1,631,671,116 (237,437 USD) constitute expenses disbursed to the Paraguayan State through the Hospital de Clínicas de San Lorenzo. Conclusion: The complications of diabetes impose considerable costs both in out-of-pocket spending, on the health sector and on the economy in general in Paraguay, so it is necessary to re-evaluate the management of this problem taking into account the great impact that these procedures have on the lives of patients on a physical, emotional, family and social level, as well as the economic burden that the treatment entails for the Health System.
Downloads
References
Oggiam, D. S. (2021, 10 febrero). Neuropathic pain screening for diabetes mellitus: a conceptual analysis. SCIELO BRASIL. Recuperado 28 de febrero de 2022, de https://www.scielo.br/j/brjp/a/WWNgJMgHDsswhpKT7hbMRdm/?format=html.
Kautzky-Willer, A., Harreiter, J., & Pacini, G. (2016). Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocrine reviews, 37(3), 278–316. https://doi.org/10.1210/er.2015-1137.
Font-Jimenez, I. (2016, 1 marzo). Factores psicosociales implicados en la amputación. Revisión sistemática de la literatura | Atención Primaria. ELSEVIER. Recuperado 28 de febrero de 2022, de https://www.elsevier.es/es-revista-atencion-primaria-27-articulo-factores-psicosociales-implicados-amputacion-revision-S0212656715002097.
Alvarsson, A., Sandgren, B., Wendel, C., Alvarsson, M., & Brismar, K. (2012). A retrospective analysis of amputation rates in diabetic patients: can lower extremity amputations be further prevented?. Cardiovascular diabetology, 11, 18. https://doi.org/10.1186/1475-2840-11-18.
Chaparro Cubilla A, Rodriguez Candia E. Amputación de miembro inferior en pacientes diabéticos del Hospital de Clínicas de Asunción – Paraguay. Una estimación de costos directos. An Univ Nac Asuncion [Internet]. 2015 [citado el 17 de agosto de 2023];44(2):23–34. Disponible en: http://archivo.bc.una.py/index.php/RP/article/view/190/123.
Mendoza Romo, M. Á., Padrón Salas, A., Cossío Torres, P. E., & Soria Orozco, M. (2017). Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano. Revista panamericana de salud pública = Revista panamericana de salud pública, 41, e103. https://doi.org/10.26633/RPSP.2017.103.
Costo del tratamiento de un diabético asciende a más de G. 3 millones al año [Internet]. Gov.py. 2015 [citado el 17 de agosto de 2023]. Disponible en: https://www.mspbs.gov.py/portal/6102/costo-del-tratamiento-de-un-diabetico-asciende-a-mas-de-g-3-millones-al-ano.html.
Xu, Z., Yu, D., Yin, X., Zheng, F., & Li, H. (2017). El estatus socioeconómico se asocia con la prevalencia mundial de la diabetes. Oncotarget, 8(27), 44434–44439. https://doi.org/10.18632/oncotarget.17902.
Ng, J., Clement, I. J., Jimeno, C., Sy, R. A., Mirasol, R., De La Pena, P., Panelo, A., Tan, R., Santillán, M., Bayani, D., & Wiebols, E. (2020). Estimación de los costos médicos directos de la diabetes mellitus tipo 2 en Filipinas: un protocolo. BMJ abierto, 10(7), e025696. https://doi.org/10.1136/bmjopen-2018-025696.
Erzse, A., Stacey, N., Chola, L., Tugendhaft, A., Freeman, M., & Hofman, K. (2019). The direct medical cost of type 2 diabetes mellitus in South Africa: a cost of illness study. Global health action, 12(1), 1636611. https://doi.org/10.1080/16549716.2019.1636611.
