Hyperbaric oxygen therapy (HBOT) has been proven to increase healing in infected diabetic foot ulcers and to be an economical adjunct in the multidisciplinary approach to limb salvage in prospective studies. The present investigation is a retrospective analysis evaluating cost effectiveness of adjunctive inpatient HBOT as applied in practice without prior focus on economic strategy. Thirty records from two hospitals in southern California were retrieved for diabetic patients admitted between 1996 and 2000 with a diagnosis of chronic, infected foot ulcer. Inpatient records and patient profiles were recorded and billing records obtained. Total inpatient days for the control group was 361 (average 24.1 per person) with ACU days > ECU days; HBOT group totaled 246 days (average 16.4 per person) with ECU days > ACU days. The average cost of inpatient stay per HBOT group patient was $37,616.27 ($2,293.68 a day) while control patients average $73,189.91 ($3,036.93 a day) per patient. Outcome data found: patients undergoing surgical procedures, 100% control vs. 53% in HBOT; patients undergoing amputations, 93% control vs 47% HBOT; multiple amputations, 20% control vs. 7% HBOT. Average cost and LOS per patient were not found to be statistically significant. Patients receiving hyperbaric oxygen therapy spent fewer days in the acute care, had a reduced number of amputations, and fewer multiple amputations.
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