In analyzing data from her experience at Madigan Army Medical Center, Dr. Driver said she found that wound depth directly correlates with number of outpatient visits. Patients with ulcers extending down to the tendon or joint capsule had an average of 30 office visits per quarter, compared with 9 per quarter for those with epithelialized wounds. Further, having an extensive and deep leg ulcer carried 40% odds of hospitalization for any and all causes within the next 3 months.
In a seminal but underreported 2004 study, researchers in the Netherlands showed that an optimal foot care program aimed at identifying and treating minor foot/leg injuries, when added to an intensive glycemic control program, could markedly reduce total cost of care per quality-adjusted life-year for people with diabetes. Foot care plus glycemic control programs had a total cost per quality-adjusted life-year of roughly $25,000. Intensive glycemic control alone had an average cost of $32,057 (Diabetes Care 2004;27:901-7).