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Title: The financial burden of diabetes-related foot disease in Australia: a systematic review.
Austin Authors: Frescos, Nicoletta;Stopher, Lucy;Jansen, Shirley;Kaminski, Michelle R
Affiliation: Austin Health
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia.
Sir Charles Gairdner Hospital, Perth, WA, Australia.;Curtin Medical School, Curtin University, Perth, WA, Australia.;Harry Perkins Institute of Medical Research, Perth, WA, Australia.
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia.;Department of Podiatry, Monash Health, Melbourne, VIC, Australia.;School of Primary and Allied healthcare, Monash University, Melbourne, VIC, Australia.
Issue Date: 27-Dec-2023
Date: 2023
Publication information: Journal of Foot and Ankle Research 2023-12-27; 16(1)
Abstract: Diabetes-related foot disease (DFD) is a common, costly, and severe complication of diabetes mellitus. DFD is associated with high rates of morbidity and mortality and poses a significant burden on patients, healthcare systems and society. While the detrimental impact of DFD is widely recognised, the precise financial implications of its management in Australia remain unclear due to inconsistent and inconclusive contemporary data. Therefore, the aim of this review was to identify, summarise and synthesise existing evidence to estimate the costs associated with DFD management in Australia. Searches were conducted in MEDLINE, Embase, AMED, CINAHL, Joanna Briggs Institute EBP, and the Cochrane Library from November 2011 to July 2023. Australian studies investigating costs associated with DFD management were eligible for inclusion. Two independent reviewers performed the study selection, data extraction and quality assessment steps. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS 2022) checklist was used to assess study quality. A descriptive analysis was performed due to limited existing evidence and large heterogeneity between study populations to conduct meta-analyses. Three economic evaluations were included in the review. One study was rated as 'poor', one as 'very good' and one as 'excellent' when assessed against the CHEERS checklist. The estimated cost of DFD management varied between studies and comparisons were not possible due to the different methodological approaches and data sources. The studies were unable to provide an overall cost of DFD with respect to all aspects of care as they did not capture the multi-faceted level of care throughout the entire patient journey between sectors and over time. There is limited contemporary evidence for the costs associated with DFD management within Australia, particularly related to direct costs and resource utilisation. Further research into the economic impact of DFD management is needed to inform optimisation of national service delivery and improve health outcomes for individuals with DFD in Australia. Integrating real-world data on impact of clinical interventions with parallel economic evaluation could be a valuable approach for future research, which would offer a more comprehensive understanding of the clinical and economic outcomes beyond solely model-based evaluations. PROSPERO Registration No. CRD42022290910.
DOI: 10.1186/s13047-023-00688-y
ORCID: 0000-0002-6355-4110
Journal: Journal of Foot and Ankle Research
Start page: 92
PubMed URL: 38151723
ISSN: 1757-1146
Type: Journal Article
Subjects: Amputation
Cost analysis
Diabetes-related foot disease
Diabetic foot
Foot ulcer
Foot Diseases/complications
Appears in Collections:Journal articles

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