Financial impact of improving diabetes‐related clinical outcomes
Published Date: 07th October 2020
Publication Authors: Bujawansa S, Furlong NJ, Narayanan RP, Westall S, Cardwell J, Mitchell L, Michaels S, Hardy KJ
Background
Our Trust received funding through the NHS Diabetes Transformation Programme to improve inpatient care and foot care. The monies received for inpatient care was used to increase the number of diabetes inpatient nurses by fivefold. We introduced extended weekday coverage (0,800–2,200), weekend cover and an emergency support line.
The funding received for developing multi‐disciplinary foot care was invested in developing joint clinics with vascular and orthopaedic surgery, increasing podiatry input by fourfold and increasing clinic capacity by 67%.
Aim
To assess the financial impact of this investment in improving clinical outcomes.
Results
Compared to 2016/17, in 2018/19 length of stay (LOS) for in patients with diabetes reduced by 0.19 days. There was a 231% increase in the number of patients with a primary diagnosis of diabetes who did not require an overnight admission. There was 0.09 day reduction in LOS compared to the reduction in LOS of inpatients without diabetes for the same period. We have saved additional 1,307 estimated bed days. This would equate to an approximate saving of £452,222.
We have reduced an estimated 3.66 major amputations/year and 14.3 minor amputations/year compared to 2015–2018. This is an approximate cost saving of £130,658. Overall, this equates to a net saving of £198,880.
Conclusions
Investment in developing effective diabetes inpatient care and foot care will deliver substantial savings through reduction in complications and avoidable harm. The annual savings generated to the local health economy could be over 50% of the annual investment.
Bujawansa, S; Furlong, N; Narayanan, P; McNulty, S; Westall, S; Cardwell, L; Mitchell, L; Michaels, S; Hardy, K. (2020). Financial impact of improving diabetes related clinical outcomes. Diabetic Medicine. 37 (S1), 15