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Original Article

Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot

Chong Rye Song1, Yong Soon Kim2, Jin Hyun Kim3
Journal of Korean Academy of Nursing Administration 2013;19(4):437-448.
Published online: September 30, 2013

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Corresponding author: Kim, Yong Soon. College of Nursing, Ajou University, San 5, Wonchun-dong, Yeongtong-gu, Suwon 443-721, Korea. Tel: +82-31-219-7010, Fax: +82-31-219-7020, ysk48@ajou.ac.kr
• Received: March 11, 2013   • Revised: May 20, 2013   • Accepted: June 9, 2013

Copyright © 2013 Korean Academy of Nursing Administration

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  • Purpose
    This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot.
  • Methods
    The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions.
  • Results
    Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients.
  • Conclusion
    Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.
  • Key Words: Diabetic foot; Home care services; Cost analysis

This article is a condensed form of the first author's doctoral dissertation from Ajou University.

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Figure 1
Scope of direct costs analysis for diabetic foot treatment.
jkana-19-437-g001.jpg
Table 1
Test of Homogeneity of Characteristics between Groups (N=60)
jkana-19-437-i001.jpg

HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; ARB=Antibiotic-Resistant Bacteria; NPWT=Negative Pressure Wound Therapy; EGF=Epidermal Growth Factors; AC=Ambulatory Care.

*Missing data excluded; †Texas university diabetic wound classification system; ‡Multiple responses; §Fisher's exact test; ∥Transforming data by natural log.

Table 2
Comparison of Direct Service Costs between Groups (Unit: Won, N=60)
jkana-19-437-i002.jpg

HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

*Missing data excluded; †Transforming data by natural log.

Table 3
Comparison of Cost-effectiveness Ratio between Groups (N=60)
jkana-19-437-i003.jpg

HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

Table 4
Factors Affecting Direct Service Costs (N=60)
jkana-19-437-i004.jpg

*Transforming data by natural log.

Table 5
Sensitivity Analysis (N=60)
jkana-19-437-i005.jpg

Length=Length of Hospital Stay; Cost=Other Medical Costs; Duration=Duration to Cure; HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; C=Cost; E=Effectiveness; C/E=Cost-effectiveness Ratio.

Figure & Data

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      Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot
      J Korean Acad Nurs Adm. 2013;19(4):437-448.   Published online September 30, 2013
      DOI: https://doi.org/10.11111/jkana.2013.19.4.437
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      Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot
      J Korean Acad Nurs Adm. 2013;19(4):437-448.   Published online September 30, 2013
      DOI: https://doi.org/10.11111/jkana.2013.19.4.437
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      Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot
      Image
      Figure 1 Scope of direct costs analysis for diabetic foot treatment.

      Figure 1

      Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot

      Test of Homogeneity of Characteristics between Groups (N=60)

      HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; ARB=Antibiotic-Resistant Bacteria; NPWT=Negative Pressure Wound Therapy; EGF=Epidermal Growth Factors; AC=Ambulatory Care.

      *Missing data excluded; †Texas university diabetic wound classification system; ‡Multiple responses; §Fisher's exact test; ∥Transforming data by natural log.

      Comparison of Direct Service Costs between Groups (Unit: Won, N=60)

      HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

      *Missing data excluded; †Transforming data by natural log.

      Comparison of Cost-effectiveness Ratio between Groups (N=60)

      HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

      Factors Affecting Direct Service Costs (N=60)

      *Transforming data by natural log.

      Sensitivity Analysis (N=60)

      Length=Length of Hospital Stay; Cost=Other Medical Costs; Duration=Duration to Cure; HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; C=Cost; E=Effectiveness; C/E=Cost-effectiveness Ratio.
      Table 1 Test of Homogeneity of Characteristics between Groups (N=60)

      HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; ARB=Antibiotic-Resistant Bacteria; NPWT=Negative Pressure Wound Therapy; EGF=Epidermal Growth Factors; AC=Ambulatory Care.

      *Missing data excluded; †Texas university diabetic wound classification system; ‡Multiple responses; §Fisher's exact test; ∥Transforming data by natural log.

      Table 2 Comparison of Direct Service Costs between Groups (Unit: Won, N=60)

      HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

      *Missing data excluded; †Transforming data by natural log.

      Table 3 Comparison of Cost-effectiveness Ratio between Groups (N=60)

      HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

      Table 4 Factors Affecting Direct Service Costs (N=60)

      *Transforming data by natural log.

      Table 5 Sensitivity Analysis (N=60)

      Length=Length of Hospital Stay; Cost=Other Medical Costs; Duration=Duration to Cure; HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; C=Cost; E=Effectiveness; C/E=Cost-effectiveness Ratio.

      Table 1

      Table 2

      Table 3

      Table 4

      Table 5

      J Korean Acad Nurs Adm : Journal of Korean Academy of Nursing Administration

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