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Healthcare Costs of Lower-Limb Amputation in U.S. Veterans with Diabetes

This study estimates the healthcare costs of diabetes-related lower-limb amputations within the Veterans Health Administration (VHA) using data from fiscal years 2004 and 2010. It highlights the economic burden and suggests improvements in diabetes care for cost savings.

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Healthcare Costs of Lower-Limb Amputation in U.S. Veterans with Diabetes

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  1. Cost of lower-limb amputation in U.S. veterans with diabetes using health services data in fiscal years 2004 and 2010 Heather Franklin, MPH; Mangala Rajan, MBA; Chin-Lin Tseng, DrPH; Len Pogach, MD, MBA; Anushua Sinja, MD, MPH

  2. Aim • Estimate healthcare costs associated with diabetes-related lower-limb amputations (LLAs) within Veterans Health Administration (VHA). • Relevance • Diabetes mellitus type 2 currently affects ~1 in 4 veterans, resulting in 10- to 20-fold increase in LLAs among those with diabetes.

  3. Method • Performed cross-sectional comparative analysis of VHA clinic users with type 2 diabetes mellitus and nontraumatic LLA. • 3,381 in fiscal year (FY) 2004. • 3,403 in FY2010. • Using VHA Health Economics Resource Center average cost files, estimated LLA expenditures for: • Inpatient medical, inpatient surgical, and outpatient care. • Obtained LLA-related pharmaceutical costs from VHA Decision Support Systems national extract files.

  4. Results • Costs (in 2012 US$) associated with care for diabetes-related LLA in VHA healthcare system: • FY2004 • Mean cost/patient = $50,351. • Total cost (3,381 patients) = $170,236,037. • FY2010 • Mean cost/patient = $60,647. • Total cost (3,403 patients) = $206,380,331.

  5. Conclusion • In VHA healthcare system, economic burden associated with LLAs in patients with diabetes exceeded $200 million in FY2010. • This suggests that further improvements in care of patients with diabetes could be associated with significant cost savings.

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