Use of the Therapeutic Footwear Benefit Among Diabetic Medicare Beneficiaries in Three States, 1995

Sugarman, Jonathan R.; Reiber, Gayle E.; Baumgardner, Greg A.; Prela, Cecilia M.; Lowery, Joseph K.

doi:10.2337/diacare.21.5.777

Cited by 27 publications

(19 citation statements)

References 2 publications

(3 reference statements)

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“…Other reports suggest a poor referral pattern for therapeutic shoes as well. In a study by Sugarman et al (11) only 2.9% of subjects with diabetes that met the criteria for “high risk” received therapeutic footwear. Although the high rate of amputation may be due to our study patients' inherent risk for foot complications, it is possible that poorly utilized prevention services played a role.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Foot Prevention

et al. 2010

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OBJECTIVETo evaluate the frequency of foot prevention strategies among high-risk patients with diabetes.RESEARCH DESIGN AND METHODSElectronic medical records were used to identify 150 patients on dialysis and 150 patients with previous foot ulceration or amputation with 30 months follow-up to determine the frequency with which patients received education, podiatry care, and therapeutic shoes and insoles as prevention services.RESULTSFew patients had formal education (1.3%), therapeutic shoes/insoles (7%), or preventative podiatric care (30%). The ulcer incidence density was the same in both groups (210 per 1,000 person-years). In contrast, the amputation incidence density was higher in the dialysis group compared with the ulcer group (58.7 vs. 13.1 per 1,000 person-years, P < 0.001). Patients on dialysis were younger and more likely to be of non-Hispanic white descent (P = 0.006) than patients with a previous history of ulcer or amputation.CONCLUSIONSPrevention services are infrequently provided to high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Diabetic Foot Prevention

et al. 2010

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“…28 We also conducted a sensitivity analysis that excluded patients who had codes indicating a lower extremity joint replacement in 2003.…”

Section: Methodsmentioning

confidence: 99%

Impact of Knee Osteoarthritis on Health Care Resource Utilization in a US Population-Based National Sample

Wright

Katz²,

Cisternas³

et al. 2010

Medical Care

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Objective We sought to estimate the impact of knee osteoarthritis (OA) on health care utilization. Research Design Using the 2003 Medicare Current Beneficiary Survey, a population-based survey of Medicare beneficiaries linked to Medicare claims, we selected a national cohort of community-dwelling persons aged 65 and older with knee OA and a sex- and age-matched comparison cohort without any form of OA. We distinguished following 4 components of health care utilization: physician (MD) office visits, non-MD office visits, inpatient hospital stays, and emergency department visits. We built multiple regression models to determine whether knee OA affects utilization, controlling for comorbidity count, obesity, functional limitation, education, race, and working status. Results A total of 545 Medicare Current Beneficiary Survey participants with knee OA were matched with 1090 OA-free individuals. Mean age in both cohorts was 76 years; approximately 70% were female. Knee OA and OA-free subjects differed significantly in obesity (Knee OA: 37%, OA-free: 20%), % with ≥2 comorbidities (Knee OA: 69%, OA-free: 43%), and functional limitation (Knee OA: 42%, OA-free: 26%). In multivariable regression models, the knee OA cohort had on average 6.0 more annual MD visits (95% confidence interval [CI]: 4.7, 7.4) and 3.8 more non-MD visits (95% CI: 2.8, 4.7) than the OA-free cohort. The knee OA cohort also had 28% more hospital stays (odds ratio [OR] = 1.3, 95% CI: 1.0, 1.6), a difference attributable to total joint replacements. Conclusions This first national, population-based study of health care utilization in persons with knee OA documents considerable excess utilization attributable to knee OA, independent of comorbidity, and other patient characteristics.

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“…However, most patients do not receive the type of clinical evaluation and standard prevention therapies that are recommended by the American Diabetes Association, the International Working Group on the Diabetic Foot, and the American College of Foot and Ankle Surgeons [15,16]. For instance, Sugarman et al [17] indicated that less than 3% of eligible diabetic patients receive therapeutic shoe and insoles in the United States.…”

Section: Failure Of Standard Prevention Therapiesmentioning

confidence: 97%

Temperature monitoring to assess, predict, and prevent diabetic foot complications

Lavery

Armstrong²

2007

Curr Diab Rep

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Preventing foot complications in high-risk patients with diabetes is often overlooked. Assessing risk factors and providing standard preventative care is low tech and relatively inexpensive. The objective of this article is to discuss standard screening and prevention practices and using temperature as a self-assessment and monitoring tool. There are a number of studies that demonstrate the impact of screening and prevention; three randomized clinical trials report a three- to 10-fold reduction in foot ulcerations among high-risk patients.

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Use of the Therapeutic Footwear Benefit Among Diabetic Medicare Beneficiaries in Three States, 1995

Cited by 27 publications

References 2 publications

Diabetic Foot Prevention

Diabetic Foot Prevention

Impact of Knee Osteoarthritis on Health Care Resource Utilization in a US Population-Based National Sample

Temperature monitoring to assess, predict, and prevent diabetic foot complications

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