We aimed to evaluate service model configuration, service capacity and accessibility of diabetes-related footcare in an Australian community health setting. Eighty-eight community-based podiatry clinics were surveyed using the selfadministered Footcare Provider Survey. Survey domains included communication, resources, service coordination and barriers to service provision. Sixty-nine from a possible 88 Victorian community podiatry clinics (78%) responded. Sixtyone (88%) provided ongoing care to individuals with diabetes-related foot disorders. Communication with vascular and orthopaedic specialists was reported to be readily available in 37% and 27% of cases respectively. Overall, communication with general practitioners was deemed readily available in 62% of cases. Just 39% of podiatrists statewide agreed overall resources were sufficient, with 26% agreeing staffing levels were adequate. Thirty-nine percent of community podiatrists used clinical care pathways, and onsite collaboration was deemed appropriate in just 30% of cases. Perceived barriers to provision of care included inadequate staffing and resources, lack of confidence from other health professionals in the podiatrists' ability to manage diabetes-related foot disorders, and lack of access to specialists.
DIABETES-RELATED FOOT DISORDERS (DRFD)encompass a range of pathologies that are largely chronic in nature. 1-3 While these pathologies may at times require hospital-based management, a significant proportion of those affected will be cared for in the community. Well defined, evidence-based clinical practice guidelines applicable to the Australian setting are available to guide clinical care of diabetes-related foot disease. 4 Community-based care is important for individuals with diabetes-related foot disorders.
What does this paper add?This study outlines a substantial lack of services and limited communication among providers, which have the potential to have a negative impact on clinical outcomes.
What are the implications for practitioners?Current service configuration and resourcing of community-based health services for individuals with diabetes-related foot disorders may be inadequate to ensure provision of evidence-based recommendations for clinical care.