Cost and Resource Utilisation for Management of Diabetes‐Related Foot Disease in Australia: An Economic Evaluation

ABSTRACT

The financial burden of diabetes‐related foot disease (DFD) in Australia remains inadequately understood. This study aimed to explore the direct costs and resource utilisation associated with DFD management, incorporating insights from healthcare professionals actively involved in the treatment of individuals with DFD. A three‐step approach informed the economic evaluation. First, a systematic review identified existing Australian cost data. Second, semi‐structured interviews with healthcare professionals generated estimates of resource utilisation and addressed data source gaps. Third, a Markov model evaluated the costs of DFD management at both the individual and health system levels. The model included direct costs related to hospital admissions, outpatient/community visits, medications, diagnostics, wound care, offloading devices and amputation‐related expenses. The average annual cost per patient for DFD management was AUD $44 691. The primary cost drivers were hospital admissions ($21 566), outpatient/community visits ($14 212) and wound debridement ($5918). The total cost to the Australian healthcare system in 2026 is estimated at AUD $3.08 billion, with projections reaching AUD $3.81 billion by 2030. This study provides essential cost estimates for DFD management at both the individual and health system levels, offering critical insights for policymakers seeking to optimise service delivery and improve patient outcomes in Australia.

Key Points

• Diabetes‐related foot disease (DFD) is costly, with an estimated annual direct medical cost of AUD $44 691 per patient in Australia.

• Hospital admissions (48%), outpatient and community care (32%), and wound debridement (13%) were identified as the major contributors to total expenditure.

• The national healthcare cost of DFD is projected to rise from AUD $3.08 billion in 2026 to AUD $3.81 billion by 2030, highlighting a growing economic burden.

• Clinician interviews revealed substantial variability in resource utilisation across services, highlighting the effects of fragmented care pathways and inconsistent access to multidisciplinary care.

• Findings emphasise a critical need for investment in prevention, early detection, timely referrals and coordinated multidisciplinary management to reduce hospitalisations and improve patient outcomes.

• This study provides contemporary, Australia‐specific cost data to inform health system planning, policy development and future economic evaluations.

1. Introduction

Diabetes mellitus is a highly prevalent chronic health condition, with over 537 million people living with diabetes worldwide [1]. A serious limb‐threatening complication of diabetes is diabetes‐related foot disease (DFD), encompassing peripheral neuropathy, peripheral artery disease, diabetes‐related foot ulceration (DFU), infection, gangrene, Charcot neuro‐osteoarthropathy and/or amputation [2]. DFUs are particularly problematic, as they often require extended periods to heal, are labour and resource intensive, and present a substantial burden to both individuals and healthcare systems. DFU is associated with reduced quality of life and is a leading cause of disability, hospitalisations and healthcare expenditure worldwide [3]. Prevalence studies indicate that DFU affects 6.3% of the global population with diabetes [4], with a lifetime incidence ranging between 19% and 34% [5]. Recurrence is also common, with 40% of ulcers reoccurring within the first year and 65% within 3 years [5, 6]. In Australia, the prevalence of DFD is estimated between 1.2% and 1.5%, while the incidence of diabetes‐related amputations ranges from 5.2 to 7.2 per 1000 person‐years [7]. Hospital admissions related to DFD in Australians with diabetes are also frequent, occurring at rates between 5.2 and 36.6 per 1000 person‐years [7].

Despite these severe outcomes, managing DFD remains a complex clinical issue. Guidelines from the International Working Group on the Diabetic Foot (IWGDF) advocate for key practices in DFD management, such as routine assessments, sharp debridement, appropriate wound care, infection management, pressure offloading and patient education [8]. The financial burden of managing DFD varies significantly across countries and depends on numerous factors, including patient characteristics (such as the severity of the ulcer), the specific interventions employed and the duration of hospital stays for specialised care and rehabilitation [9]. The healthcare costs associated with DFD management can encompass a wide range of expenses, including medical consultations, wound bed preparation and dressing supplies, medications, diagnostic tests, pressure offloading devices, prostheses, hospitalisations and surgical procedures [10, 11].

The global financial impact of diabetes is substantial, with annual healthcare expenditure estimated at US $966 billion [1]. In the United States (US), direct annual costs for diabetes management are around US $237 billion, with one‐third of this amount attributable to DFD [12]. In the United Kingdom (UK), annual expenditure for DFD is estimated between £837 and £962 million per year (data from 2014 to 2015) [11]. In Europe, the total direct and indirect costs associated with DFD management at the individual level range from €7722 to €20 064 per annum [11]. In Australia, the direct costs of managing DFD have been estimated at AUD $1.09 billion for the public hospital system and AUD $2.69 billion for the overall healthcare system [13].

Our recent systematic review [14] highlighted that there is limited contemporary evidence for the costs associated with DFD management in Australia, particularly related to direct costs and resource utilisation. A limitation of previous Australian cost‐effectiveness analyses [9, 15] and economic evaluations [16] is the reliance on international data to inform specific model inputs, due to the limited published Australian cost and resource utilisation data available. Therefore, these estimates may not be a true reflection of the cost burden in Australia. This lack of local data is likely due to fragmented DFD care provision often seen in Australia, limited rebateable services through government‐funded benefits, and previously a lack of consistent national data collection methods [14].

An economic evaluation that incorporates the perspectives of multidisciplinary healthcare professionals (HCPs) across Australia is now essential. Such an evaluation will provide a crucial foundation for future research and policy development, enabling more informed decision‐making regarding resource allocation. Therefore, this study aimed to explore the direct costs and resource utilisation associated with DFD management in Australia by incorporating insights from Australian HCPs involved in the treatment of individuals with DFD.

2. Materials and Methods

This study has been reported in accordance with the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement [17]. A three‐step approach (Figure 1) obtained contemporary data on the direct costs and resource utilisation for DFD management in Australia.

FIGURE 1.

Three‐step methodological approach.

2.1. Step 1: Systematic Review

A systematic review was undertaken to assess the current evidence on the direct costs of DFD management in Australia over the last decade. Detailed methods are described in a previous publication [14]. In brief, searches were performed in six medical databases (MEDLINE, Embase, AMED, CINAHL, Joanna Briggs Institute EBP and the Cochrane Library) and included Australian studies investigating costs associated with DFD management. Two independent reviewers conducted the study selection, data extraction and quality assessment. The Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement [17] was used to evaluate study quality. Due to the limited available evidence and significant variability among study populations, a descriptive analysis was conducted rather than a meta‐analysis.

2.2. Step 2: Semi‐Structured Interviews

This study received approval from the relevant Human Research and Ethics Committee (HEC21406) and all participants provided informed consent prior to data collection.

To generate estimates of resource utilisation (due to the absence of alternative Australian data sources), a qualitative approach using semi‐structured interviews was used to explore Australian HCPs' perspectives on treatment pathways, standards of care for management of DFD, resource utilisation and associated costs. The study sample was purposefully selected to ensure a diverse representation across different specialties and geographical locations within Australia, considering both professional backgrounds and expertise of the HCPs involved. One‐hour semi‐structured interviews were conducted online with expert HCPs actively involved in the management of DFD. A pre‐defined discussion guide was used, developed to address knowledge gaps identified in our prior systematic review [14]. This guide was initially piloted with three experts—a podiatrist, a wound care nurse consultant and a vascular surgeon—and was adapted based on their feedback. Participants were also asked to estimate resource utilisation by completing a structured table that outlined the resources needed for DFD management. These estimates were provided for four states of DFD: closed wound (healed), active wound, open wound post‐amputation and closed wound post‐amputation.

2.3. Step 3: Economic Evaluation

2.3.1. Markov Model

The Markov model is a predictive model commonly used to analyse medical decisions and perform economic evaluations [10, 18]. This method of modelling disease such as DFU, is relevant, because it can take into account both the chronicity of the disease and the repeating risk of events over time (e.g., amputation) [10, 19, 20]. Markov models describe the world in a realistic way and are a useful tool to make long‐term predictions about a system or process, in our case, estimating the average cost of DFD management per patient per year in Australia.

2.3.2. Model Structure

A model‐based economic evaluation was conducted to estimate the average annual cost per patient for DFD management. The analysis was performed from an Australian healthcare system perspective and the cost was expressed in 2026 Australian dollars, with a discount rate of 5% [21]. A Markov model was employed to simulate patient movement between seven defined health states, based on 23 transition probabilities, over a 1‐year time horizon with weekly cycle lengths. Upon entering the model, a patient with diabetes is initially in the ‘open wound’ state, from which they may transition to a ‘closed wound’ state (indicating healing) or to a ‘complicated’ state (indicating infection), which leads to delayed healing. Complicated wounds may lead to amputation, after which the patient transitions to a post‐amputation state. In this model, it is assumed that amputations occur only once and only while patients are in the complicated state.

The model used in this study is an adaptation of the Markov model (Figure 2) developed by Manchester University and Urgo Medical and has been validated by the National Institute for Health and Care Excellence (NICE), UK. It has been previously used to compare the cost‐effectiveness of different treatments for DFU [22], but in this study, we focused on cost estimates for DFD management at both the individual and health system levels. Inputs for the 23 transition probabilities within the model were informed by existing literature [23].

FIGURE 2.

Markov model.

2.3.3. Data Sources

The data sources and assumptions used to inform the Markov model are detailed in Tables 1 and 2. Unit costs for healthcare services and resources for the economic evaluation were sourced from existing literature [14], the Medicare Benefits Schedule [27], the IHACPA National Efficient Price Determination 2025–26 [28], market prices at the time of the study, and data obtained from the semi‐structured interviews with expert HCPs. The Markov model accounted for direct costs associated with hospital admissions, outpatient and community specialist visits, community nursing, medications, diagnostic tests, wound care, offloading devices and amputation‐related expenses. These inputs were used to estimate both the average annual cost of DFD management per patient and the projected five‐year costs for the Australian healthcare system (Tables 3 and 4).

TABLE 1.

Markov model inputs and sources.

Inputs for cost estimation	Data sources
Time horizon	1 year
Perspective	Australian health care system (MSAC guidelines)
Discount rate	5% (MSAC guidelines)
Proportion with prior amputations	50% (assumption)
Transition probabilities	Existing literature
Unit costs ($AUD)	MBS data, AR‐DRG data, IHACPA National Efficient Price Determination, existing literature, clinical expert interviews
Frequency of resource use	Clinical expert interviews, existing literature

Abbreviations: AR‐DRG, Australian refined diagnosis‐related groups; IHACPA, Independent Health and Aged Care Pricing Authority; MBS, Medicare Benefits Schedule; MSAC, Medical Services Advisory Committee.

TABLE 2.

Assumptions for 5‐year cost estimation.

Parameter	People	Sources/assumptions
Population, people aged 18 and over	27 309 396	Australian Bureau of Statistics [24]
Annual population growth	1.8%	Australian Bureau of Statistics [24]
Estimated prevalence of diabetes	6.6%	Australian Bureau of Statistics [25]
Number of people with diabetes in Australia	1 802 420	Population multiplied by existing prevalence
Estimated annual incidence of diabetes	0.4%	Diabetes Australia [26] 300 × 365 a
Number of people diagnosed with diabetes each year	109 500	Population multiplied by annual incidence
Total number of people with diabetes	1 911 920	Prevalent population plus incident population
Estimated annual incidence of foot ulceration in people with diabetes	3.6%	Zhang et al. [7]
Total number of people with diabetes and foot ulceration	68 829	Number of people with diabetes multiplied by annual incidence of foot ulceration

^a Number of people diagnosed with diabetes per day multiplied by number of days in the year.

TABLE 3.

Resource allocation and unit costs for management of diabetes‐related foot disease.

	Expenditure	Unit cost ($AUD)	Resource utilisation (weighted average)
			Open DFU (pre‐amputation)	Open DFU (post‐amputation)	Closed DFU (pre‐amputation)	Closed DFU (post‐amputation)
Ongoing costs
Hospital inpatient (days/year)	Admissions	4542.78	10.0	6.6	1.4	1.1
Hospital outpatient visits (per year)	Visits	355.64	25.4	25.1	3.7	4.0
Healthcare practitioners (visits/year)	General practitioner	88.50	12.0	5.8	3.1	2.7
	Podiatrist	72.65	24.9	15.9	7.1	6.5
	Practice nurse	14.00	60.1	55.8	1.4	1.4
	Community nurse	17.50	77.3	80.0	0.3	0
	Multidisciplinary team	544.35	17.7	18.4	1.3	0.6
	Other healthcare professional/specialist	—	3.0	—	1.5	3.1
Medications (prescriptions/year)	Antibiotics	35.08	2.8	2.6	0	0.5
	Analgesics	45.00	0.5	0.5	0	0
Wound dressings (dressings/week)	Primary and secondary dressings	11.40	2.8	3.9	0.1	0.2
Devices (per year)	Custom foot orthoses	350.00	1.8	1.4	0.8	0.8
	Pressure offloading devices (range from $17 to $96)	50.00	1.1	1.4	0.3	0.6
Other costs	Wound debridement (no. of visits/patient/year)	380.35	33.1	24.4	1.6	1.6
	Other wound debridement	—	2.0	0.8	—	0
	X‐ray of foot	45.85	2.1	—	—	—
	Microscopy, culture and sensitivities (patient/year)	22.00	2.3	1.8	0.1	0.1
Event costs
Amputation‐related costs (lower limb)	Minor amputation	30 530.00	—	—	—	—
	Major amputation	47 327.00
	Physiotherapy	290.60
	Prosthesis	5000.00

TABLE 4.

Average cost of resources per patient per annum.

Item	Cost per patient per year ($AUD)
Hospital inpatient ($21 566)
Admissions	21 566
Outpatient/community visits ($14 212)
Hospital outpatient	5432
General practitioner	616
Multidisciplinary team	6031
Podiatry	1026
Practice nurse	420
Community nurse	687
Medications ($77)
Antibiotics	65
Analgesics	12
Diagnostics ($54)
Microscopy, culture and sensitivities	24
X‐ray of foot	30
Devices/consumables ($1437)
Primary/secondary dressings	1016
Pressure offloading devices	39
Custom foot orthoses	382
Wound debridement ($5918)	5918
Amputation‐related events ($1428)
Minor amputation	923
Major amputation	452
Physiotherapy	12
Prosthesis	41
Total	44 691

Note: Average taken from patients transitioning through different health states within the Markov model.

In the absence of alternative data sources, estimates for resource utilisation were derived from the semi‐structured interviews with expert HCPs. This is an approach that has precedence in both published literature and Health Technology Assessment submissions [29, 30]. To estimate overall resource use, a weighted average was applied to account for variations among clinicians, as well as differences between larger and smaller centres, and between metropolitan and rural or remote centres.

3. Results

3.1. Systematic Review

The systematic review [14] identified three Australian studies: one economic evaluation [16] and two cost‐effectiveness analyses [9, 15], which found variation in cost estimates for DFD management and limited evidence on direct costs and resource utilisation. The studies were unable to provide an overall cost of DFD with respect to all aspects of care as they did not capture the multi‐faceted level of care throughout the entire patient journey between sectors and over time [14].

3.2. Semi‐Structured Interviews

Thirteen HCPs participated in the interviews, with 12 completing the resource utilisation table. Among the 13 expert HCPs, there were five podiatrists, two endocrinologists, one vascular surgeon, one prosthetist and orthotist, two nurses (nurse practitioner and vascular nurse), one general practitioner and one researcher. The majority were female (75%) and 84% worked in public hospitals. Geographically, participants were located in New South Wales (n = 2), Queensland (n = 2), Tasmania (n = 1), Victoria (n = 4) and Western Australia (n = 3). While most worked in metropolitan areas (92%), three HCPs served rural and remote communities. Their years of experience ranged from 7 to 30 years [31]. The quantitative data found variations in the frequency and types of resources used (Table 3) and was dependent on the HCP, the practice setting and the procurement arrangements.

3.3. Economic Evaluation

The Markov model estimated the average annual cost per patient for DFD management is AUD $44 691 (Table 4). Hospital admissions represented 48% of the overall cost ($21 566), followed by outpatient/community visits (including hospital outpatient, general practitioner, multidisciplinary team, podiatry and nursing) at 32% ($14 212) and by wound debridement at 13% ($5918). The remainder of the costs ($2995) were attributed to devices/consumables (3%), amputation‐related events (3%), medications (< 1%) and diagnostics (< 1%) (Table 4 and Figure 3). The total cost to the Australian healthcare system in 2026 was estimated at AUD $3.08 billion, with projections reaching AUD $3.81 billion by 2030 (Figure 4).

FIGURE 3.

Average cost of resources per patient per annum.

FIGURE 4.

Projected 5‐year cost estimates for the Australian healthcare system. Precise costs: $3 076 054 824 (2026), $3 255 398 563 (2027), $3 437 970 490 (2028), $3 623 828 712 (2029) and $3 813 032 382 (2030).

4. Discussion

DFD imposes a substantial financial burden on individuals and the healthcare system. Our economic evaluation estimated the average annual direct medical cost per patient at AUD $44 691, covering hospitalisations, outpatient and community care, medications, wound management (e.g., conservative sharp debridement, dressings and pressure offloading), diagnostics and lower‐limb amputations. Nationally, the cost of managing DFD in Australia is projected to increase from AUD $3.08 billion to AUD $3.81 billion over the next 5 years, highlighting the urgency for effective management strategies and preventive measures.

This cost reflects the complex and diverse presentations of DFD. Foot ulcers may heal within weeks, persist for years or progress to amputation. The chronic and insidious nature of DFD, particularly when complicated by peripheral artery disease and/or infection, often necessitates prolonged and intensive treatment, escalating both the demand for resources and financial support required for patients, healthcare providers and society.

International comparisons show that DFD consistently incurs high costs, despite differing healthcare systems. In European countries (2003/2004 data) the estimated direct and indirect annual cost per patient ranges between €7722 and €20 064 [32]. A systematic review [33] used International dollars (Int$) ¹ and reported annual outpatient care costs of Int$15 180 in France (1999 data), Int$10 572 per ulcer in Belgium (2000 data) and Int$24 965 per patient in Sweden (1986–1995 data) [33]. More recent figures regarding annual costs per patient from the United States (Int$28 644, 2007–2010 data) and Canada (Int$22 994, 2000 data) further support the high economic impact [33, 34]. In the UK, the cost of primary, community and outpatient care is Int$7539 per patient (2014–2015 data), totalling Int$514 million annually [11, 33]. A Malaysian study [35] with comparable methodology to our study used a Markov model and estimated that the annual per patient public healthcare cost is MYR 5981 (2021 data), providing a more recent comparison from a different region.

In our analysis, the largest proportion of costs was attributed to hospital admissions (48%), followed by outpatient and community care (32%) and wound debridement (13%). Recurrent infections remain a key driver of hospitalisation and escalating costs [34, 36]. Delayed referrals and fragmented care pathways may exacerbate infection severity, increasing hospital length of stay and costs, thus reinforcing the need for better preventive measures and management strategies to reduce recurrence [37, 38, 39, 40]. During interviews, HCPs consistently described debridement as a frequent and essential component of DFD management, with many patients requiring repeated conservative sharp debridement—often weekly or even more depending on wound severity and chronicity. The cumulative nature of this intervention means that ongoing debridement contributes substantially to overall costs, particularly for non‐healing chronic or recurrent ulcers. These observations are consistent with recommendations in international guidelines and existing clinical evidence [8, 41].

Amputation‐related costs were relatively low (3%), likely due to the lower transition probability to that health state. Conversely, chronic and infected ulcers—more common presentations—require prolonged, resource‐intensive care. Compared to the Malaysian study [35], which attributed 39% of annual costs to dressings and orthoses, our lower estimate (3%) likely reflects partial or full subsidies within Australia's public healthcare system. Similarly, outpatient and community care accounted for a high proportion of costs in both our study and the Malaysian study (32% vs. 31%, respectively), suggesting systemic similarities in care delivery models.

Interestingly, antibiotic prescriptions accounted for less than 1% of total costs. This could reflect effective antimicrobial stewardship, underreporting in the Pharmaceutical Benefits Scheme (PBS)—particularly for prescriptions by endorsed professionals such as podiatrists—or missed treatment opportunities. As prescribing pathways expand (e.g., podiatrists gaining endorsement for scheduled medicines), early intervention patterns may shift. Although outside this study's scope, the Australian Diabetes Foot Registry [42] may offer future insights into prescribing and care trends.

A related concern is wound‐related pain, with up to 86% of patients with peripheral neuropathy reporting such pain [43]. Despite this, analgesic prescriptions accounted for less than 1% of total costs, raising questions about the adequacy of pain assessment and management in this patient group. This finding aligns with existing literature suggesting wound‐related pain remains under‐addressed in DFD care [44].

4.1. Strengths and Limitations

This study provides a detailed, contemporary and context‐specific analysis for the direct medical costs of DFD in Australia, supporting healthcare planning and policy decisions. A major strength is the mixed‐methods approach, integrating a systematic review of local cost data; semi‐structured interviews with multidisciplinary experts across varied geographic regions and a validated Markov model estimating costs across different health states.

However, several limitations should be considered. First, the accuracy of cost estimates is contingent on the quality and completeness of available data. Given the complex and multifaceted nature of DFD, along with the variability in management practices across healthcare settings, the data may not fully capture all aspects of resource utilisation. Future longitudinal studies involving large, diverse cohorts across clinical settings are needed to improve precision and generalisability. Such studies would improve the granularity of economic data and better reflect the full spectrum of care pathways and associated costs. Second, while we captured a wide range of direct costs, this study did not include costs associated with revascularisation, Charcot neuro‐osteoarthropathy or indirect costs such as lost income/productivity, reduced quality of life or caregiver burden. These factors significantly contribute to the broader economic impact and should be included in future evaluations. Third, our estimates may not fully reflect regional cost variations or differences in patient populations. While our sample included HCPs from various states of Australia, including those with outreach roles in rural and remote areas, their input was aggregated using weighted averages to derive national estimates; this design does not enable stratified modelling by geography. Therefore, further studies are needed to assess the financial impact of DFD in First Nations communities and remote settings. Forth, because we did not collect patient‐level demographic or behavioural data, stratified subgroup analyses could not be performed. This includes analyses by age group, occupation, geographical location or adherence behaviours.

4.2. Future Research Directions

Future research should expand economic evaluations of DFD to capture indirect costs, patient‐reported outcomes, cost‐effectiveness of specific treatments and the long‐term financial impact. These elements are essential for building a more comprehensive understanding of the true economic burden of DFD. Evaluating the cost‐effectiveness of preventative and early intervention strategies is also critical. Such research could help identify approaches that not only reduce healthcare costs but also minimise patient morbidity by improving clinical outcomes. There is a particular need for studies investigating emerging technologies—such as telehealth, wearable diagnostics and advanced wound care products—to determine their value in both clinical and economic terms.

Integrating real‐world data will significantly improve the relevance and robustness of future economic evaluations and cost‐effectiveness analyses. This includes data from national registries, such as the Australian Diabetes Foot Registry, and administrative sources like the PBS. Using these datasets could enhance the accuracy of resource utilisation estimates and support evaluation of interventions in real‐world settings. Future studies should also incorporate patient‐level demographic, clinical and behavioural factors to enable stratified cost analyses across subgroups. Such granularity would support more targeted resource allocation and help identify populations at greatest economic risk.

Based on existing clinical evidence and international recommendations [8] there is a pressing need to invest in strategies that improve healing times and reduce the need for high‐cost interventions. Interventions that promote prevention, early detection, timely wound care and improved diabetes and foot care management have the potential to reduce treatment duration and overall costs. As new treatments and technologies continue to emerge, their economic impact must be carefully assessed to inform healthcare policy and investment decisions. This will require collaborative efforts among researchers, clinicians and policymakers to ensure that strategies are designed and implemented effectively, with the ultimate goal of reducing the burden of DFD.

While this study offers a critical overview of current DFD‐related costs, ongoing research and improved economic modelling are essential to refine these estimates. Future efforts may include systematic reviews, analysis of publicly available datasets and prospective studies that track resource utilisation in real‐world care settings. A combination of these approaches will strengthen the evidence base and extend the impact of the current research.

4.3. Study Implications

This body of work provides important cost estimates for the management of DFD in Australia, with implications at both the individual and health system levels. The significant expenditure identified highlights the urgent need for greater investment in prevention, particularly within primary care. Our findings suggest that early intervention, targeted patient and HCP education and coordinated multidisciplinary care could reduce some of the key cost drivers, such as hospital admissions and length of stay, while also improving health outcomes. These insights align with broader calls for healthcare reform that prioritises proactive and evidence‐based approaches to DFD management.

Prior studies have shown that guideline‐based care not only improves patient quality of life but also enhances overall cost‐effectiveness [9, 15]. Building on these findings through further cost‐effectiveness analyses and real‐world implementation studies will help strengthen the case for integrated, sustainable models of care. It is clear that targeted, timely and cost‐effective strategies are essential to managing DFD within Australia's healthcare system. Interventions such as early detection and prevention programmes, advanced wound care and multidisciplinary team‐based approaches should be prioritised to reduce long‐term healthcare expenditure and improve patient outcomes.

Further research is particularly needed to evaluate the economic impact of these interventions in rural and remote communities and among underserved populations, including First Nations peoples. This will help inform more equitable resource allocation and support the delivery of care tailored to population needs.

Overall, this study provides valuable insights to inform healthcare policy and service delivery in Australia. By investing in prevention, early detection and evidence‐based care models, the healthcare system can reduce the economic burden of DFD while delivering better, more sustainable outcomes for patients.

5. Conclusions

This study highlights the substantial and growing financial burden of managing DFD in Australia. With national costs projected to rise, our findings identify hospital admissions, outpatient and community visits and wound debridement as the primary cost drivers. Recurrent infections, delayed referrals and fragmented care can further escalate expenses, reinforcing the need for early intervention and coordinated management. While our estimates are based on the best available data, they likely underestimate the full economic impact, as indirect costs—such as lost income/productivity and caregiver burden—were beyond the study's scope. Effective prevention and early detection strategies, advanced wound care and integrated multidisciplinary team‐based approaches are essential to improving patient outcomes and reducing long‐term healthcare expenditure. Future research should focus on evaluating the cost‐effectiveness of such interventions, particularly in rural, regional and remote regions of Australia and in underserved populations. These insights could guide more equitable and efficient resource allocation. Investing in proactive, evidence‐based models of care offers an opportunity to improve outcomes for individuals with DFD while enhancing the long‐term sustainability of Australia's healthcare system.

Funding

An unconditional grant was received from URGO Medical Australia; however, they had no role in the conceptualisation, design, data collection, analysis, decision to publish or preparation of the manuscript.

Ethics Statement

This study was approved by the La Trobe University Human Research and Ethics Committee (HEC21406).

Consent

All participants provided informed consent prior to data collection.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.