The Ministry of Health has published a regulation on a pilot program for diabetic foot syndrome care. Up to a dozen percent of diabetic patients struggle with this health problem.
Pilot of care for patients with diabetic foot syndrome is being prepared
Published July 3, 2023 10:35
fot. iStock
As the IA reads, the proposal contained in the draft was based on the experience and preliminary results of the patient treatment program conducted at the Independent Public Health Care Center in Szamotuly. These activities have been carried out at the above-mentioned center for almost two years. Existing solutions in this area, i.e. Coordinated Treatment of Chronic Wounds, assume an extensive program based on a stretched out in time and assuming multi-center cooperation, in a process of universal character for the treatment of chronic wounds regardless of their cause.
The program to date has failed to guarantee universal access throughout the country. The solution presented in the draft focuses on the inpatient treatment phase, assuming minimal necessary surgical intervention and follow-up conservative treatment and control of healing progress.
The purpose of the pilot program is to test the treatment provided by a team that includes specialists from both the surgical (general surgery) and conservative (internal medicine) departments, which, if successful, can guarantee the universality of the adopted solution. At the same time, the current regulations in this regard prevent the aggregation of services performed during a single hospitalization in both departments. An additional benefit of the treatment plan proposed in the draft is to guarantee follow-up visits, during which the progress of healing will be assessed.
According to data from the National Health Fund (NHF), the cost of all high amputations in people with diabetes amounted to about PLN 44 million in 2018 alone, and so-called secondary amputations, i.e., amputations after vascular intervention, account for 26.5 to 44.6 percent of cases, which means that the effect of a successful vascular procedure and the substantial financial sum transferred for revascularization by the NHF payer do not produce the expected end results of saving the limb from amputation,
The mainstay of care for patients with diabetic foot syndrome, as a rule, is outpatient services, but there is a significant percentage of patients who require inpatient treatment.
The number of high amputations in Poland (just below or just above the knee) is about 4,500 per year. Their rates in our country are 2-3 times higher than the corresponding amputation rates in France, the Netherlands, the United Kingdom, as well as Italy.
