ORIGINAL ARTICLE The cost utility of a multi-disciplinary foot protection clinic (MDFPC) in an Irish hospital setting G. J. Nason • H. Strapp • C. Kiernan • K. Moore • J. Gibney • T. M. Feeley • B. Egan • S. Tierney Received: 26 June 2011 / Accepted: 31 March 2012 / Published online: 21 April 2012 Ó Royal Academy of Medicine in Ireland 2012 Abstract Background Foot ulceration which may result in lower limb amputation is one of the most feared complications among patients with diabetes and the prevention of both ulceration and amputation is a major challenge facing the health service. Many studies have proposed dedicated diabetic foot teams as the future of diabetic foot care. Aims We aimed to quantify the cost benefit and sustain- ability of a multi-disciplinary foot protection clinic (MDFPC) in an Irish university hospital setting. Methods A dedicated bi-weekly consultant-led MDFPC including Vascular Surgery, Endocrinology, Orthopaedic Surgery, Podiatry, Orthotics and Tissue Viability was established in June 2008. Results Between 2006 and 2010, a total of 221 lower limb procedures (major/minor amputations and debride- ment) were performed. The number of major amputations decreased from 12 during the control period (2 years before the clinic) to 7 in the study period (2 years after the clinic). After costing all activity associated with the clinic, there was an overall saving of €114,063 per year associated with the introduction of the MDFPC. Conclusion This is the first study in an Irish context, and one of few international studies, to demonstrate that an aggressive-coordinated approach to diabetic foot care is both cost effective and clinically efficient in reducing the burden of foot-related complications in a diabetic population. Keywords Cost Á Foot protection clinic Á Diabetes Introduction Diabetes is a growing problem and foot complications in those with diabetes place a significant social, psychological and economic strain on patients and the health service [1, 2]. The lifetime incidence of foot ulceration in diabetics has been estimated as high as 25 % [3], and up to 85 % of diabetic lower extremity amputations are preceded by ulceration and diabetic foot infection [4]. Many studies have advocated dedicated diabetic foot teams as the mainstay of diabetic foot care [5, 6] with patient education, risk factor modification and an aggres- sive preventative approach reported to reduce the ampu- tation rate by more than 50 % [7]. Nowadays, it is generally accepted that a multi-disciplinary approach reduces amputation rates but recent evidence also suggests that the costs for implementing diabetic foot teams may be offset over the long-term by improved access to care and reductions in foot complications and in amputation rates [8]. Despite evidence supporting the benefits of dedicated foot teams, they are not yet standard in all hospitals in Ireland or elsewhere. The cost of managing diabetic foot complications is difficult to quantify and at present there is paucity of Irish data in the literature regarding the diabetic foot, complications or management. In 2004, in an Irish hospital setting, Smith et al. [1] concluded that ‘the man- agement of diabetic foot complications placed a significant G. J. Nason (&) Á H. Strapp Á C. Kiernan Á T. M. Feeley Á B. Egan Á S. Tierney Department of Vascular Surgery, Adelaide and Meath (incorporating the National Children’s) Hospital, Tallaght, Dublin 24, Ireland e-mail: nasong@tcd.ie K. Moore Á J. Gibney Department of Endocrinology, Adelaide and Meath (incorporating the National Children’s) Hospital, Tallaght, Dublin 24, Ireland 123 Ir J Med Sci (2013) 182:41–45 DOI 10.1007/s11845-012-0823-8