Abstract | OBJECTIVE: To determine effectiveness of receipt of care from podiatrist and lower extremity clinician specialists (LEC specialists) on diabetes mellitus (DM)-related lower extremity amputation. DATA SOURCES: Medicare 5 percent sample claims, 1991-2007. STUDY DESIGN: Individuals with DM-related lower extremity complications (LECs) were followed 6 years. Visits with podiatrists, LEC specialists, and other health professionals were tracked to ascertain whether receipt of such care reduced the hazards of an LEC amputation. DATA COLLECTION: PRINCIPAL FINDINGS: Half the LEC sample died within 6 years. More severe lower extremity disease increased risk of death and amputation. Persons visiting a podiatrist and an LEC specialist within a year before developing all stage complications were between 31 percent (ulceration) and 77 percent ( cellulitis and charcot foot) as likely to undergo amputation compared with individuals visiting other health professionals. CONCLUSIONS: Individuals with an LEC had high mortality. Visiting both a podiatrist and an LEC specialist in the year before LEC diagnosis was protective of undergoing lower extremity amputation, suggesting a benefit from multidisciplinary care.
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Authors | Frank A Sloan, Mark N Feinglos, Daniel S Grossman |
Journal | Health services research
(Health Serv Res)
Vol. 45
Issue 6 Pt 1
Pg. 1740-62
(Dec 2010)
ISSN: 1475-6773 [Electronic] United States |
PMID | 20722748
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © Health Research and Educational Trust. |
Topics |
- Aged
- Amputation, Surgical
(statistics & numerical data)
- Delivery of Health Care
(statistics & numerical data)
- Diabetes Complications
(surgery, therapy)
- Female
- Humans
- Leg
(surgery)
- Male
- Medicine
- Podiatry
- United States
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