Excess Cost and Healthcare Resources Associated With Delayed Diagnosis of Charcot Foot

Jonathan M. Labovitz, Jarrod M. Shapiro, V. Kathleen Satterfield, Nathanael T. Smith

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

The purpose of the present study was to demonstrate the effect of a delayed diagnosis of Charcot foot on acute care cost and usage. We used International Classification of Disease, Ninth Revision, Clinical Modification codes, and the California Office for Statewide Health Planning and Development 2009 to 2012 public patient discharge files to identify patients with type 2 diabetes mellitus and Charcot foot. The costs and length of stay were compared for those with a diagnosis of Charcot foot on admission compared with those who received a delayed diagnosis of Charcot foot before discharge. Patient demographic data, diagnoses often mistaken for Charcot foot, and procedures often performed for Charcot foot were assessed to determine the potential effect on costs and length of stay in Charcot foot subjects. A delayed Charcot foot diagnosis was associated with 10.8% greater inpatient costs and 12.1% longer length of stay. These patients required greater resource usage owing to the significantly greater number of procedures performed. A significantly greater number of patients underwent lower extremity amputation when the diagnosis was delayed, resulting in a 30.4% increase in costs and 31.6% longer length of stay. A greater rate of diabetic foot ulcers, foot infections, and osteomyelitis was also observed; however, the cost was only affected by osteomyelitis, and the length of stay was not significantly affected. A delayed diagnosis of Charcot foot at admission resulted in significantly increased acute care costs and longer lengths of stay.

Original languageEnglish (US)
Pages (from-to)952-956
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume57
Issue number5
DOIs
StatePublished - Sep 1 2018
Externally publishedYes

Keywords

  • 3
  • Charcot foot
  • cost
  • delayed diagnosis
  • length of stay

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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