Cost Analysis

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Hyperbaric oxygen therapy, when used as adjunctive care to chronic disease management and traditional wound care treatment, has shown to be a cost-effective method toward limb savage, rehabilitation and healing thereby helping to reduce the cost of frequent medical and surgical procedures.

A closer look at the cost of diabetes provides insight into skyrocketing costs of managing chronic disease.

Cost of Diabetes

There are 20.8 million children and adults or 7 percent of the U.S. population who have diabetes. According to the American Diabetes Association, the total direct and indirect costs of diabetes in 2002 was estimated to be $132 billion or one out of every ten healthcare dollars spent in the United States. Direct medical treatment accounted for $92 billion and $40.8 billion covered indirect costs including disability and mortality.

According to a study published by the National Institutes of Health, foot ulcers in diabetic patients contribute to more than half of lower extremity amputations in the United States in a group at risk representing only three percent of the population.

Direct Costs of Diabetes (2002):
(Source: American Diabetes Association, “Direct and Indirect Costs of Diabetes in the United States”)

• Represents 11 percent of the total personal healthcare expenditures in the United States
• $40.3 billion was spent for inpatient hospitalization and $13.8 billion for nursing home care
• Diabetes-related hospitalization totaled 16.9 million days
• Outpatient care rates were highest for physician office visits (62.6 million)

Georgia Facts:

• There are 511,000 adults in Georgia With diagnosed kiabetes — up from 202,000 in 1994 (Centers for Disease Control and Prevention
• In 2005, the age-standardized prevalence of diagnosed diabetes per 100 adults in Georgia exceeded 8 percent (Centers for Disease Control and Prevention)
• In 2004, there are 217,000 known diabetes patients and 108,000 who have diabetes but don’t know it (”2006 Georgia Data Summary: Diabetes”, Georgia Department of Human Resources — Division of Public Health)

Cost of Treating Non-Healing Lower Extremity Diabetic Ulcers

The Undersea and Hyperbaric Medical Society’s 1999 Committee Report states the cost of treating non-healing lower extremity diabetic ulcers totals more than $200 million annually. In the United States, lower limb diabetic complications account for:

• More than 20 percent of diabetes-related hospitalizations
• More than 60 percent of non-traumatic amputations (From 1997 to 1999, more than 82,000 amputations were performed.)

Average hospitalization cost: $31,264
Average amputation cost: $40,000 ($12,500 Medicare reimbursement)
Estimated Total (excluding indirect costs*): $71,264

*Add an average of $30,000 per patient for rehabilitation and related medical and surgical disability care

TOTAL: $101,264

According to the American Diabetes Association, more than 60 percent of non-traumatic lower limb amputations occur in people with diabetes. In 2002, about 82,000 non-traumatic lower limb amputations were performed in people with diabetes.

An Economic Analysis of Adjunctive Hyperbarc Oxygen Therapy for Diabetic Foot Wounds

Hyperbaric oxygen therapy is more effective than standard care alone.

• Major lower extremity amputations decreased from 32% to 11%.

Hyperbaric oxygen therapy is cost effective compared to standard care alone.

• 19% reduction in overall health care costs (12-year costs).
• Large increase in quality adjusted life years.

Hailey D, Jacobs P, Perry DC, et al. 2007
Canadian Agency for Drugs and Technologies in Health; Report No. 75 www.cadth.ca

Cost Benefit of Hyperbaric Oxygen Therapy

Early hyperbaric oxygen therapy treatment early in hospitalization increases revascularization to help prevent amputations and further complications. hyperbaric oxygen therapy has been shown to decrease major amputations by more than 75 percent (International Hyperbaric Medicine Association). Limb salvage is significant to direct and indirect costs of diabetes including hospitalization, rehabilitation, and Social Security Disability Income costs.