[A specialized outpatient foot clinic for diabetic patients decreases the number of amputations and is cost saving]

Abstract

Objective: Evaluation of the effectiveness of a foot clinic for diabetes patients.

Design: Retrospective study and cost-effect analysis.

Setting: Spaarne Hospital, Heemstede.

Method: The effectiveness of 5 years's activity (1987-1991) of a foot clinic was measured by comparing its patient population, the presenting ulcers and amputations, the average stay in hospital and the cost reduction with 1983-1986.

Results: From 1987 to 1991 4323 diabetic check-ups were done in the clinic, of which 810 were first referrals. Of these first referrals 112 presented with a leg ulcer. Compared with the period before the establishment of the clinic in 1987, hospital admission for diabetic foot problems decreased from 48 to 29 days and 30 admissions could be prevented. The number of amputations decreased by 43%. The reduction in costs was calculated to be about Dfl. 325,000.--annually.

Conclusion: A specialised foot clinic reduces morbidity and cost in diabetes foot care. Central figures in this clinic are a chiropodist and a nurse, supported by a surgeon and specialists in internal diseases, rehabilitation and footwear.