Economic burden of podiatric care for diabetic foot ulcers in Czech Republic: Prospective multicenter study
Aims
(DF), especially (DFUs) are a relatively frequent and financially burdensome late-stage . However, data on the costs of podiatric care in the Czech Republic are scarce. The aim of this prospective multicenter study was to determine the total costs associated with long-term podiatric care in selected foot clinics across the Czech Republic.
Research Design and Methods
A total of 119 patients with DFUs (mean age of 68 ± 11 years, diabetes duration of 19 ± 11 years, level of 62 ± 14 mmol/mol, composite score of 3 ± 2, 33 % had new DFUs, 37 % previous amputations, and 50 % had (PAD)) from 10 podiatric foot clinics in the Czech Republic were enrolled in our financial analysis. Direct and indirect costs associated with podiatric care − diagnostic and treatment methods – including angiological, radiological, and , blood sampling, prescribed materials for local therapy, antibiotics, surgical procedures, offloading devices, hospital services and additional expenses such as patient transportation, doctors’ visits, home care assistance, and work incapacity – were monitored over a 6-month period using an electronic database.
Results
The average cost of podiatric care per patient over a 6-month period was €2,506 with median €1,320. The largest expenses were spent on therapeutic procedures (51.4 %). Costs for patients hospitalized during the study period were significantly higher than for outpatients (€7,923 vs. €1,304 on average; P < 0.001). Among hospitalized patients, the main costs were hospital services (32 %), therapeutic procedures (26 %), and and local therapies (20 %). Among outpatients, therapeutic procedures accounted for 74 % of the total costs. Newly developed DFUs or PAD were not linked to significantly increased costs. The composite score, primarily the wound component, was the only parameter that significantly positively correlated with the total podiatric costs (r = 0.434; 95 % CI 0.279–0.559; P < 0.0001). Other such as age, diabetes duration, DFU duration, and level did not show significant cost correlations.
Conclusions
On average, podiatric care for patients with DFUs in the Czech Republic is 3 to 9 times more expensive than standard diabetes healthcare. The expenses for hospitalized patients are almost 6 times higher than for outpatients. The composite score was the most significant indicator of podiatric financial burden.
https://doi.org/10.1016/j.diabres.2025.112141
Published: 18 July 2025