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dc.contributor.authorBarshes, N. R.
dc.contributor.authorSaedi, S.
dc.contributor.authorWrobel, J.
dc.contributor.authorKougias, P.
dc.contributor.authorKundakcıoğlu, Ömer Erhun
dc.contributor.authorArmstrong, D. G.
dc.date.accessioned2017-06-17T13:54:21Z
dc.date.available2017-06-17T13:54:21Z
dc.date.issued2017
dc.identifier.issn1873-460X
dc.identifier.urihttp://hdl.handle.net/10679/5353
dc.identifier.urihttp://www.jdcjournal.com/article/S1056-8727(16)30414-7/fulltext
dc.description.abstractBackground: Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. Methods: A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes. Clinical event and cost estimates were obtained from previously-published trials and studies. A population without previous DFU but with 17% neuropathy and 11% peripheral artery disease (PAD) prevalence was assumed. Primary prevention (PP) was defined as reducing initial DFU incidence. Results: PP was more than 90% likely to provide cost-savings when annual prevention costs are less than $50/person and/or annual DFU incidence is reduced by at least 25%. Efforts directed at patients with diabetes who were at moderate or high risk for DFUs were very likely to provide cost-savings if DFU incidence was decreased by at least 10% and/or the cost was less than $150 per person per year. Conclusions: Low-cost DFU primary prevention efforts producing even small decreases in DFU incidence may provide the best opportunity for cost-savings, especially if focused on patients with neuropathy and/or PAD. Mobile phone-based reminders, self-identification of risk factors (ex. Ipswich touch test), and written brochures may be among such low-cost interventions that should be investigated for cost-savings potential.
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.ispartofJournal Of Diabetes And Its Complications
dc.rightsrestrictedAccess
dc.titleA model to estimate cost-savings in diabetic foot ulcer prevention effortsen_US
dc.typeArticleen_US
dc.publicationstatuspublisheden_US
dc.contributor.departmentÖzyeğin University
dc.contributor.authorID(ORCID 0000-0003-3033-0986 & YÖK ID 124068) Kundakcıoğlu, Erhun
dc.contributor.ozuauthorKundakcıoğlu, Ömer Erhun
dc.identifier.startpage700
dc.identifier.endpage707
dc.identifier.wosWOS:000401047000010
dc.subject.keywordsDiabetic foot ulcer
dc.subject.keywordsPrevention
dc.subject.keywordsCost-utility study
dc.subject.keywordsCost-effectiveness
dc.subject.keywordsEconomic evaluation
dc.subject.keywordsAmputation
dc.identifier.scopusSCOPUS:2-s2.0-85011076214
dc.contributor.authorMale1


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