Cost Estimation of Detection of Peripheral Arterial Disease by Pulse Oximeter among Diabetic Patients and Assessing Its Feasibility at Family Health Centers in Alexandria

Background: Peripheral arterial disease (PAD) is more common in diabetic patients as compared to non-diabetic people, with a high risk of lower limb ischemia, ulcer, and amputation. Pulse oximetry is a simple technique that can be used to estimate foot arterial oxygen saturation for early PAD detection in diabetic patients. Objective(s): The study aimed to estimate the cost of detection of PAD by pulse oximeter (PO) among diabetic patients as well as assess its feasibility at family health centers/units (FHC/Us) in Alexandria. Methods: A mixed cost estimation – feasibility (qualitative) study was conducted in Alexandria health directorate and eight FHC/Us in Alexandria. Key figures at Alexandria health directorate and FHC/Us were interviewed to assess the cost and feasibility of introducing PO for early PAD detection in diabetic patients at the FHC/Us. Results: The cost of using PO at FHC/Us for PAD detection in one diabetic patient was 185.9 EGP (Egyptian Pound) for a positive PAD in one foot after confirming the diagnosis with doppler ultrasonography at secondary healthcare facilities. Pulse oximeter was considered a simple, easy screening tool that can have a positive impact on primary health care (PHC) diabetic patients. Conclusion: The cost of PAD detection in one foot is considered very low and relatively affordable in relation to the cost of the consequences of PAD progression in diabetic patients. Integration of PO requires some interventions such as staff training and working environment preparedness.