Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 8, 2014
   Pages 1325 — 1330

Abstract — Cost of lower-limb amputation in U.S. veterans with diabetes using health services data in fiscal years 2004 and 2010

Heather Franklin, MPH;1–2 Mangala Rajan, MBA;1–3 Chin-Lin Tseng, DrPH;1,3 Len Pogach, MD, MBA;1,3 Anushua Sinha, MD, MPH1–3*

1Department of Veterans Affairs New Jersey Health Care System, East Orange Campus, East Orange, NJ; 2Department of Quantitative Methods, Rutgers School of Public Health, Newark, NJ; 3Department of Preventive Medicine and Community Health, New Jersey Medical School, Rutgers–The State University of New Jersey, Newark, NJ

Abstract — The purpose of this study was to estimate healthcare costs associated with diabetes-related lower-limb amputations (LLAs) within the Veterans Health Administration (VHA). We performed a cross-sectional comparative analysis of 3,381 VHA clinic users in fiscal year (FY) 2004 and 3,403 VHA clinic users in FY2010 identified as having type 2 diabetes mellitus and nontraumatic LLA. LLA expenditures related to inpatient medical, inpatient surgical, and outpatient care were estimated using VHA Health Economics Resource Center average cost files. LLA-related pharmaceutical costs were obtained from VHA Decision Support Systems national extract files. From the Department of Veterans Affairs (VA) perspective, the mean cost associated with care for diabetes-related LLA per patient in the VA healthcare system in FY2004 was $50,351 (95% confidence interval [CI] = 48,939–51,803) in 2012 U.S. dollars; the total cost for all 3,381 patients was $170,236,037. In FY2010, cost per patient rose to $60,647 (95% CI = 59,143–62,188), with a total cost of $206,380,331 for 3,403 patients. In the VHA healthcare system, the economic burden associated with LLAs in patients with diabetes exceeded $200,000,000 in FY2010. This suggests that further improvements in care of patients with diabetes could be associated with significant cost savings.

Key words: amputations, cost, diabetes, health services, LLA expenditures, lower-limb amputations, VA, veteran, Veterans Health Administration, VHA.


View HTML ¦ View PDF ¦ Contents Vol. 51, No.8

This article and any supplementary material should be cited as follows:
Franklin H, Rajan M, Tseng C, Pogach L, Sinha A. Cost of lower-limb amputation in U.S. veterans with diabetes using health services data in fiscal years 2004 and 2010. J Rehabil Res Dev. 2014;51(8):1325–30.
http://dx.doi.org/10.1682/JRRD.2013.11.0249
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