Cost of diabetes-related amputations in minorities

Hisham R. Ashry, Lawrence A. Lavery, David G. Armstrong, David C. Lavery, William H. Van Houtum

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

The objective of this study was to identify the direct cost and length of hospitalization of diabetes-related lower extremity amputations among Hispanics, African Americans, non-Hispanic whites, and Asians. The authors used a database from the office of Statewide Planning and Development in California that identified all hospitalizations for lower extremity amputations in the state in 1991. Amputation level was defined by the ICD-9- CM codes 84.11-84.18. The total hospital charges for diabetes-related lower extremity amputations for the state of California in 1991 was $141 million. The mean hospital charge (HC) per patient with all ethnic groups combined was $27,930; and the mean length of stay (LOS) was 15.9 days. African Americans had significantly higher mean charges ($32,383) and longer stays (17.3 days) compared to all other ethnic groups (p < .05). Toe-level amputations had lower HC (p < .05) and LOS (p < .01) than other amputation levels for all race groups. One-quarter of the population received multiple amputations during their hospital stay. These patients incurred significantly higher hospital charges ($44,731) and stayed in the hospital longer (23.4 days) than those receiving only a single amputation. There was a considerable variation in the HC and LOS among ethnic groups by level of amputation. The direct charges reported in this study suggest considerably higher overall direct costs than have been previously reported in the medical literature. The greater burden of disease experienced by African Americans is probably related to their higher amputation cost and longer hospitalization.

Original languageEnglish (US)
Pages (from-to)186-190
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume37
Issue number3
StatePublished - May 1998

Fingerprint

Amputation
Hospital Charges
Costs and Cost Analysis
Length of Stay
Ethnic Groups
African Americans
Lower Extremity
Hospitalization
Toes
International Classification of Diseases
Hispanic Americans
Databases

Keywords

  • African American
  • Amputation
  • Cost
  • Diabetes mellitus
  • Hispanic
  • Hospitalization lower extremity

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Ashry, H. R., Lavery, L. A., Armstrong, D. G., Lavery, D. C., & Van Houtum, W. H. (1998). Cost of diabetes-related amputations in minorities. Journal of Foot and Ankle Surgery, 37(3), 186-190.

Cost of diabetes-related amputations in minorities. / Ashry, Hisham R.; Lavery, Lawrence A.; Armstrong, David G.; Lavery, David C.; Van Houtum, William H.

In: Journal of Foot and Ankle Surgery, Vol. 37, No. 3, 05.1998, p. 186-190.

Research output: Contribution to journalArticle

Ashry, HR, Lavery, LA, Armstrong, DG, Lavery, DC & Van Houtum, WH 1998, 'Cost of diabetes-related amputations in minorities', Journal of Foot and Ankle Surgery, vol. 37, no. 3, pp. 186-190.
Ashry HR, Lavery LA, Armstrong DG, Lavery DC, Van Houtum WH. Cost of diabetes-related amputations in minorities. Journal of Foot and Ankle Surgery. 1998 May;37(3):186-190.
Ashry, Hisham R. ; Lavery, Lawrence A. ; Armstrong, David G. ; Lavery, David C. ; Van Houtum, William H. / Cost of diabetes-related amputations in minorities. In: Journal of Foot and Ankle Surgery. 1998 ; Vol. 37, No. 3. pp. 186-190.
@article{62d7e945accb4ef7b1c6a6e6f31d5063,
title = "Cost of diabetes-related amputations in minorities",
abstract = "The objective of this study was to identify the direct cost and length of hospitalization of diabetes-related lower extremity amputations among Hispanics, African Americans, non-Hispanic whites, and Asians. The authors used a database from the office of Statewide Planning and Development in California that identified all hospitalizations for lower extremity amputations in the state in 1991. Amputation level was defined by the ICD-9- CM codes 84.11-84.18. The total hospital charges for diabetes-related lower extremity amputations for the state of California in 1991 was $141 million. The mean hospital charge (HC) per patient with all ethnic groups combined was $27,930; and the mean length of stay (LOS) was 15.9 days. African Americans had significantly higher mean charges ($32,383) and longer stays (17.3 days) compared to all other ethnic groups (p < .05). Toe-level amputations had lower HC (p < .05) and LOS (p < .01) than other amputation levels for all race groups. One-quarter of the population received multiple amputations during their hospital stay. These patients incurred significantly higher hospital charges ($44,731) and stayed in the hospital longer (23.4 days) than those receiving only a single amputation. There was a considerable variation in the HC and LOS among ethnic groups by level of amputation. The direct charges reported in this study suggest considerably higher overall direct costs than have been previously reported in the medical literature. The greater burden of disease experienced by African Americans is probably related to their higher amputation cost and longer hospitalization.",
keywords = "African American, Amputation, Cost, Diabetes mellitus, Hispanic, Hospitalization lower extremity",
author = "Ashry, {Hisham R.} and Lavery, {Lawrence A.} and Armstrong, {David G.} and Lavery, {David C.} and {Van Houtum}, {William H.}",
year = "1998",
month = "5",
language = "English (US)",
volume = "37",
pages = "186--190",
journal = "Journal of Foot and Ankle Surgery",
issn = "1067-2516",
publisher = "Academic Press Inc.",
number = "3",

}

TY - JOUR

T1 - Cost of diabetes-related amputations in minorities

AU - Ashry, Hisham R.

AU - Lavery, Lawrence A.

AU - Armstrong, David G.

AU - Lavery, David C.

AU - Van Houtum, William H.

PY - 1998/5

Y1 - 1998/5

N2 - The objective of this study was to identify the direct cost and length of hospitalization of diabetes-related lower extremity amputations among Hispanics, African Americans, non-Hispanic whites, and Asians. The authors used a database from the office of Statewide Planning and Development in California that identified all hospitalizations for lower extremity amputations in the state in 1991. Amputation level was defined by the ICD-9- CM codes 84.11-84.18. The total hospital charges for diabetes-related lower extremity amputations for the state of California in 1991 was $141 million. The mean hospital charge (HC) per patient with all ethnic groups combined was $27,930; and the mean length of stay (LOS) was 15.9 days. African Americans had significantly higher mean charges ($32,383) and longer stays (17.3 days) compared to all other ethnic groups (p < .05). Toe-level amputations had lower HC (p < .05) and LOS (p < .01) than other amputation levels for all race groups. One-quarter of the population received multiple amputations during their hospital stay. These patients incurred significantly higher hospital charges ($44,731) and stayed in the hospital longer (23.4 days) than those receiving only a single amputation. There was a considerable variation in the HC and LOS among ethnic groups by level of amputation. The direct charges reported in this study suggest considerably higher overall direct costs than have been previously reported in the medical literature. The greater burden of disease experienced by African Americans is probably related to their higher amputation cost and longer hospitalization.

AB - The objective of this study was to identify the direct cost and length of hospitalization of diabetes-related lower extremity amputations among Hispanics, African Americans, non-Hispanic whites, and Asians. The authors used a database from the office of Statewide Planning and Development in California that identified all hospitalizations for lower extremity amputations in the state in 1991. Amputation level was defined by the ICD-9- CM codes 84.11-84.18. The total hospital charges for diabetes-related lower extremity amputations for the state of California in 1991 was $141 million. The mean hospital charge (HC) per patient with all ethnic groups combined was $27,930; and the mean length of stay (LOS) was 15.9 days. African Americans had significantly higher mean charges ($32,383) and longer stays (17.3 days) compared to all other ethnic groups (p < .05). Toe-level amputations had lower HC (p < .05) and LOS (p < .01) than other amputation levels for all race groups. One-quarter of the population received multiple amputations during their hospital stay. These patients incurred significantly higher hospital charges ($44,731) and stayed in the hospital longer (23.4 days) than those receiving only a single amputation. There was a considerable variation in the HC and LOS among ethnic groups by level of amputation. The direct charges reported in this study suggest considerably higher overall direct costs than have been previously reported in the medical literature. The greater burden of disease experienced by African Americans is probably related to their higher amputation cost and longer hospitalization.

KW - African American

KW - Amputation

KW - Cost

KW - Diabetes mellitus

KW - Hispanic

KW - Hospitalization lower extremity

UR - http://www.scopus.com/inward/record.url?scp=0031841688&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031841688&partnerID=8YFLogxK

M3 - Article

VL - 37

SP - 186

EP - 190

JO - Journal of Foot and Ankle Surgery

JF - Journal of Foot and Ankle Surgery

SN - 1067-2516

IS - 3

ER -