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

Chong Rye Song; Yong Soon Kim; Jin Hyun Kim

doi:10.11111/jkana.2013.19.4.437

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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

DOI: https://doi.org/10.11111/jkana.2013.19.4.437

¹Department of Nursing, Ajou University Hospital, Korea.

²College of Nursing, Ajou University, Korea.

³College of Nursing, Seoul National University, Korea.

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

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Abstract
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REFERENCES

Abstract

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

Article Information

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

REFERENCES

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Figure 1

Scope of direct costs analysis for diabetic foot treatment.

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.

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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

Figure

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

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

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)

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)

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

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