Journal List > J Korean Acad Nurs Adm > v.19(4) > 1051698

Song, Kim, and Kim: Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot



This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot.


The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions.


Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients.


Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

Figures and Tables

Figure 1
Scope of direct costs analysis for diabetic foot treatment.
Table 1
Test of Homogeneity of Characteristics between Groups (N=60)

HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; ARB=Antibiotic-Resistant Bacteria; NPWT=Negative Pressure Wound Therapy; EGF=Epidermal Growth Factors; AC=Ambulatory Care.

*Missing data excluded; Texas university diabetic wound classification system; Multiple responses; §Fisher's exact test; Transforming data by natural log.

Table 2
Comparison of Direct Service Costs between Groups (Unit: Won, N=60)

HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

*Missing data excluded; Transforming data by natural log.

Table 3
Comparison of Cost-effectiveness Ratio between Groups (N=60)

HC=Home Care Services Group; Non-HC=Non-Home Care Services Group.

Table 4
Factors Affecting Direct Service Costs (N=60)

*Transforming data by natural log.

Table 5
Sensitivity Analysis (N=60)

Length=Length of Hospital Stay; Cost=Other Medical Costs; Duration=Duration to Cure; HC=Home Care Services Group; Non-HC=Non-Home Care Services Group; C=Cost; E=Effectiveness; C/E=Cost-effectiveness Ratio.


This article is a condensed form of the first author's doctoral dissertation from Ajou University.


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