Health Economic Aspects of Diabetes Foot Complications: Results from Patients survey

Abstract

Diabetes foot is common complication of late diabetes. It causes not only severe morbidity and infirmity but also results
significant health economic consequences. Evidence proves that majority of diabetic foot cases are complicated and
mainly diagnosed in surgical departments of the hospitals in Georgia, which represents less cost-effective approach.
The proposed research assessed health economic consequences of diabetes foot patients in the capital city - Tbilisi and 5
regions of Georgia. For this purpose, quantitative survey of diabetes foot patients was conducted using face-to-face personal interview method. The patients were interviewed by preliminary trained nurse-podiatrists after visiting diabetes
foot rooms (exit interviews). In total, 126 patients with diabetes foot complications were interviewed. The survey indicated that the households of patients with diabetes foot problems have considerably low income compared to their medical expenditure. Diabetes foot patients usually experience out-of-pocket payments during outpatient visits as Universal
Healthcare Program (UHP) mainly covers emergency and inpatient services (e.g. amputations). Additionally, UHP does
not cover patients’ expenses on pharmaceuticals. As a result 64% of surveyed patients with diabetic foot problems cannot afford to buy necessary medicines. The survey indicated high rates of risky behavior and low awareness of patients
on issues related to disease prevention and healthy life-style. Due to financial problems and absence of proper services,
only 18% of diabetes patients with foot complications wear special shoes. The survey results clearly indicated that appropriate changes in the Governmental policy and programs are required. The major issue is to switch focus of state
healthcare programs from expensive and high resource consuming in-patient care to much more cheap and effective
preventive outpatient services.