Prevalence and Medical Resource of Patients with Diabetic Foot Ulcer: A Nationwide Population-Based Retrospective Cohort Study for 2001–2015 in Taiwan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Definition of Diabetes Foot Ulcer and Medical Resource
2.3. Statistical Analysis
3. Results
3.1. General Characteristics of the Participants
3.2. DFU Prevalence
3.3. Medical Expenditure Due to DFU
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | n | Percentage |
---|---|---|
Age | ||
20–45 | 641 | 8.5 |
45–65 | 3329 | 44.3 |
≥65 | 3541 | 47.2 |
CCI | ||
0 | 927 | 12.3 |
1 | 1504 | 20.0 |
2 | 1883 | 25.1 |
≥3 | 3197 | 42.6 |
Gender | ||
Male | 4194 | 55.8 |
Female | 3317 | 44.2 |
Education level | ||
Below Elementary school | 4455 | 59.3 |
Middle school | 1289 | 17.2 |
High school | 1223 | 16.3 |
College or above | 544 | 7.2 |
Location of residence | ||
North | 2548 | 33.9 |
Central | 2820 | 37.5 |
South | 1636 | 21.8 |
East | 507 | 6.8 |
Marital status | ||
unmarried | 561 | 7.5 |
married | 4995 | 66.5 |
divorced/widowed | 1955 | 26.0 |
Socioeconomic status | ||
Low | 3497 | 46.5 |
Moderate | 3702 | 49.3 |
High | 312 | 4.2 |
Amputation | 1400 | 18.6 |
Debridement | 2806 | 37.4 |
Comorbidity (1 year before the DFU diagnosis) | ||
Diabetes | 5335 | 71.0 |
Hypertension | 4158 | 52.6 |
Coronary heart disease | 1851 | 24.6 |
Ulcer disease | 1340 | 17.8 |
Cerebrovascular disease | 1282 | 17.1 |
Chronic pulmonary disease | 1220 | 16.2 |
Moderate or severe renal disease | 1128 | 15.0 |
Mild liver disease | 703 | 9.4 |
Peripheral vascular disease | 679 | 9.0 |
Congestive heart failure | 616 | 8.2 |
Dementia | 285 | 3.8 |
Hemiplegia | 106 | 1.4 |
Variable | Median | IQR |
Overall consultation status | ||
Number of outpatient visits | 170 | 71–325 |
Outpatient fees (USD) | 8234.59 | 3073.52–17,854.97 |
Number of hospitalizations | 4 | 2–9 |
Hospitalization fees (USD) | 257,897 | 3166.34–20,807.52 |
Length of hospitalization (days) | 42 | 15–99 |
DFU consultation status | ||
Number of outpatient visits | 2 | 1–6 |
Outpatient fees (USD) | 52.62 | 24.48–144.14. |
Number of hospitalizations | 1 | 1–2 |
Hospitalization fees (USD) | 1954.72 | 817.86–4372.48. |
Length of hospitalization (days) | 13 | 7–26 |
Variable | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
DM patient (N) | 61,593 | 67,038 | 71,429 | 80,325 | 86,465 | 93,261 | 102,017 | 111,391 | 122,841 | 129,375 | 136,305 | 143,912 | 151,313 | 157,103 | 162,873 |
DM prevalence (%) | 4.75 | 5.04 | 5.24 | 5.77 | 6.09 | 6.46 | 6.95 | 7.45 | 8.08 | 8.43 | 8.81 | 9.22 | 9.60 | 9.87 | 10.15 |
DFU prevalence (%) | |||||||||||||||
Overall | 0.53 | 0.64 | 0.63 | 0.73 | 0.76 | 0.70 | 0.69 | 0.69 | 0.68 | 0.68 | 0.69 | 0.61 | 0.58 | 0.60 | 0.52 |
Gender | |||||||||||||||
Male | 0.56 | 0.72 | 0.72 | 0.80 | 0.85 | 0.76 | 0.78 | 0.80 | 0.79 | 0.77 | 0.82 | 0.71 | 0.68 | 0.70 | 0.58 |
Female | 0.50 | 0.57 | 0.55 | 0.66 | 0.67 | 0.65 | 0.60 | 0.59 | 0.58 | 0.58 | 0.55 | 0.50 | 0.47 | 0.49 | 0.46 |
Age | |||||||||||||||
20–50 | 0.37 | 0.57 | 0.47 | 0.57 | 0.59 | 0.49 | 0.56 | 0.50 | 0.53 | 0.51 | 0.50 | 0.47 | 0.51 | 0.50 | 0.43 |
50–65 | 0.53 | 0.65 | 0.71 | 0.76 | 0.73 | 0.69 | 0.65 | 0.67 | 0.62 | 0.63 | 0.62 | 0.53 | 0.56 | 0.53 | 0.43 |
≥65 | 0.70 | 0.70 | 0.68 | 0.81 | 0.90 | 0.85 | 0.80 | 0.82 | 0.83 | 0.80 | 0.84 | 0.75 | 0.62 | 0.70 | 0.65 |
Socioeconomic status | |||||||||||||||
Low | 0.56 | 0.64 | 0.63 | 0.66 | 0.74 | 0.71 | 0.74 | 0.75 | 0.69 | 0.73 | 0.74 | 0.64 | 0.64 | 0.63 | 0.60 |
Middle | 0.55 | 0.69 | 0.68 | 0.84 | 0.83 | 0.75 | 0.69 | 0.68 | 0.72 | 0.69 | 0.69 | 0.63 | 0.58 | 0.61 | 0.50 |
High | 0.19 | 0.27 | 0.39 | 0.41 | 0.40 | 0.34 | 0.32 | 0.41 | 0.39 | 0.30 | 0.38 | 0.31 | 0.25 | 0.32 | 0.27 |
Location of residence | |||||||||||||||
North | 0.36 | 0.44 | 0.47 | 0.56 | 0.50 | 0.55 | 0.54 | 0.57 | 0.53 | 0.57 | 0.53 | 0.50 | 0.49 | 0.50 | 0.45 |
Central | 0.57 | 0.72 | 0.68 | 0.76 | 0.88 | 0.74 | 0.76 | 0.75 | 0.72 | 0.72 | 0.73 | 0.63 | 0.61 | 0.63 | 0.57 |
South | 0.76 | 0.91 | 0.90 | 1.03 | 1.07 | 0.91 | 0.89 | 0.79 | 0.87 | 0.81 | 0.86 | 0.79 | 0.67 | 0.69 | 0.58 |
East | 0.81 | 0.79 | 0.71 | 0.79 | 0.92 | 0.99 | 0.69 | 0.96 | 1.05 | 0.81 | 1.09 | 0.73 | 0.70 | 0.83 | 0.58 |
Marital status | |||||||||||||||
unmarried | 0.51 | 0.70 | 0.66 | 0.67 | 0.86 | 0.76 | 0.78 | 0.81 | 0.74 | 0.83 | 0.86 | 0.67 | 0.78 | 0.62 | 0.58 |
married | 0.50 | 0.61 | 0.58 | 0.70 | 0.72 | 0.69 | 0.64 | 0.64 | 0.61 | 0.62 | 0.63 | 0.57 | 0.52 | 0.58 | 0.47 |
divorced/widowed | 0.69 | 0.78 | 0.94 | 0.90 | 0.86 | 0.73 | 0.82 | 0.83 | 0.91 | 0.82 | 0.84 | 0.73 | 0.68 | 0.62 | 0.69 |
Education level | |||||||||||||||
Below Elementary school | 0.66 | 0.81 | 0.84 | 0.92 | 0.96 | 0.90 | 0.80 | 0.84 | 0.87 | 0.82 | 0.84 | 0.75 | 0.70 | 0.75 | 0.68 |
Middle school | 0.53 | 0.66 | 0.56 | 0.73 | 0.74 | 0.68 | 0.80 | 0.71 | 0.74 | 0.75 | 0.80 | 0.69 | 0.62 | 0.62 | 0.56 |
High school | 0.37 | 0.47 | 0.32 | 0.49 | 0.51 | 0.50 | 0.58 | 0.59 | 0.48 | 0.53 | 0.54 | 0.50 | 0.50 | 0.53 | 0.43 |
College or above | 0.24 | 0.21 | 0.34 | 0.36 | 0.36 | 0.31 | 0.30 | 0.32 | 0.28 | 0.34 | 0.32 | 0.26 | 0.30 | 0.30 | 0.23 |
Variable | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Patients with DFU | 325 | 429 | 453 | 585 | 655 | 657 | 700 | 771 | 840 | 875 | 935 | 875 | 872 | 937 | 849 |
Debridement (%) | 16.6 | 15.4 | 16.1 | 19.0 | 15.7 | 15.7 | 17.1 | 17.6 | 19.3 | 19.1 | 16.9 | 12.6 | 14.9 | 16.1 | 14.1 |
Amputation (%) | 1.2 | 2.8 | 3.8 | 4.1 | 5.0 | 5.6 | 5.4 | 6.6 | 5.6 | 6.1 | 7.0 | 4.8 | 4.9 | 5.1 | 4.7 |
Number of outpatient visits * | 2 (1–5) | 2 (1–4) | 2 (1–5) | 2 (1–6) | 2 (1–5) | 2 (1–5) | 2 (1–5) | 2 (1–6) | 2 (1–4) | 2 (1–5) | 2 (1–6) | 2 (1–6) | 2 (1–5) | 2 (1–5) | 2 (1–5) |
Outpatient fees (USD) * | 48.59 (21.21–127.10) | 36.03 (21.10–105.59) | 47.79 (21.28–141.03) | 57.07 (23.76–175.55) | 47.14 (24.38–119.48) | 44.76 (22.97–120.10) | 50.45 (22.21–131.38) | 53.79 (23.34–141.86) | 50.62 (22.53–122.14) | 49.97 (23.10–128.93) | 51.38 (25.10–146.03) | 57.59 (25.66–164.17) | 51.69 (25.07–138.79) | 49.59 (23.59–137.17) | 49.21 (25.03–139.03) |
Number of hospitalizations * | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1(1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) | 1 (1–1) |
Hospitalization fees (USD) * | 925.90 (486.41–1808.10) | 1176.91 (537.45–2439.83) | 1259.03 (565.07–2726.69) | 1340.90 (701.72–2917.59) | 1609.86 (701.72–3693.03) | 1397.55 (718.45–2799.31) | 1457.59 (728.48–3797.52) | 1606.10 (781.00–3395.59) | 1806.52 (771.00–3512.07) | 1668.86 (810.21–3398.07) | 1730.41 (847.38–3424.97) | 1523.79 (871.86–3016.83) | 1815.79 (887.52–4084.45) | 1982.34 (903.83–3795.62) | 1949.24 (905.97–3873.03) |
Length of hospitalization (days) * | 8 (5–18) | 10 (5–24) | 11 (6–22) | 11 (7–24) | 11 (6–21) | 11 (6–20) | 10 (5–24) | 11 (6–22) | 12 (6–22) | 10 (6–20) | 11 (6–20) | 10 (6–18) | 11 (6–20) | 11 (6–21) | 10 (6–19) |
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Tai, C.-H.; Hsieh, T.-C.; Lee, R.-P.; Lo, S.-F. Prevalence and Medical Resource of Patients with Diabetic Foot Ulcer: A Nationwide Population-Based Retrospective Cohort Study for 2001–2015 in Taiwan. Int. J. Environ. Res. Public Health 2021, 18, 1891. https://doi.org/10.3390/ijerph18041891
Tai C-H, Hsieh T-C, Lee R-P, Lo S-F. Prevalence and Medical Resource of Patients with Diabetic Foot Ulcer: A Nationwide Population-Based Retrospective Cohort Study for 2001–2015 in Taiwan. International Journal of Environmental Research and Public Health. 2021; 18(4):1891. https://doi.org/10.3390/ijerph18041891
Chicago/Turabian StyleTai, Chia-Hui, Tsung-Cheng Hsieh, Ru-Ping Lee, and Shu-Fen Lo. 2021. "Prevalence and Medical Resource of Patients with Diabetic Foot Ulcer: A Nationwide Population-Based Retrospective Cohort Study for 2001–2015 in Taiwan" International Journal of Environmental Research and Public Health 18, no. 4: 1891. https://doi.org/10.3390/ijerph18041891