A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings

Gayle E. Reiber, Douglas G. Smith, Janette Carter, Greg Fotieo, H. Gunner Deery, Jon A. Sangeorzan, Lawrence Lavery, Jacueline Pugh, Bettine Peter-Riesch, Jean Phillipe Assal, Michael Del Aguila, Paula Diehr, Donald L. Patrick, Edward J. Boyko

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To compare patients with diabetes and new onset foot ulcers treated in Veterans Health Administration (VHA) and non-VHA settings. Methods: The treatment of patients with new onset diabetic foot ulcers was prospectively monitored in three VHA and three non-VHA hospitals and outpatient settings until ulcer healing, amputation, or death. Results: Of the 302 individuals enrolled in this study, 47% were veterans receiving VHA care. There were no significant differences between veterans and nonveterans in baseline wound classification, diabetes severity, or comorbid conditions. Veterans received significantly fewer sharp debridements, total contact casts, and custom inserts than their nonveteran counterparts, and they had significantly more x-rays, local saline irrigations, IV antibiotics, and prescriptions for bed rest. The percentage of amputations was higher in veterans but did not achieve statistical significance. Conclusions: Many commonly held stereotypes of veteran men were not found. Veterans and nonveterans with foot ulcers were similar in terms of health and foot history, diabetes severity, and comorbid conditions. There was considerable variation in treatment of diabetic foot ulcers between VHA and non-VHA care. Yet this variation did not result in statistically significant differences in ulcer outcomes.

Original languageEnglish (US)
Pages (from-to)309-317
Number of pages9
JournalJournal of Rehabilitation Research and Development
Volume38
Issue number3
StatePublished - 2001

Fingerprint

Veterans Health
United States Department of Veterans Affairs
Diabetic Foot
Veterans
Health
Foot Ulcer
Medical problems
Amputation
Ulcer
Hospital Administration
Delivery of Health Care
Bed Rest
Debridement
Prescriptions
Foot
Antibiotics
Outpatients
History
Irrigation
X-Rays

Keywords

  • Amputation
  • Diabetes mellitus
  • Diabetic foot
  • Foot ulcers
  • Treatment
  • Wound healing

ASJC Scopus subject areas

  • Rehabilitation
  • Health Professions(all)
  • Engineering(all)

Cite this

Reiber, G. E., Smith, D. G., Carter, J., Fotieo, G., Gunner Deery, H., Sangeorzan, J. A., ... Boyko, E. J. (2001). A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings. Journal of Rehabilitation Research and Development, 38(3), 309-317.

A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings. / Reiber, Gayle E.; Smith, Douglas G.; Carter, Janette; Fotieo, Greg; Gunner Deery, H.; Sangeorzan, Jon A.; Lavery, Lawrence; Pugh, Jacueline; Peter-Riesch, Bettine; Assal, Jean Phillipe; Del Aguila, Michael; Diehr, Paula; Patrick, Donald L.; Boyko, Edward J.

In: Journal of Rehabilitation Research and Development, Vol. 38, No. 3, 2001, p. 309-317.

Research output: Contribution to journalArticle

Reiber, GE, Smith, DG, Carter, J, Fotieo, G, Gunner Deery, H, Sangeorzan, JA, Lavery, L, Pugh, J, Peter-Riesch, B, Assal, JP, Del Aguila, M, Diehr, P, Patrick, DL & Boyko, EJ 2001, 'A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings', Journal of Rehabilitation Research and Development, vol. 38, no. 3, pp. 309-317.
Reiber GE, Smith DG, Carter J, Fotieo G, Gunner Deery H, Sangeorzan JA et al. A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings. Journal of Rehabilitation Research and Development. 2001;38(3):309-317.
Reiber, Gayle E. ; Smith, Douglas G. ; Carter, Janette ; Fotieo, Greg ; Gunner Deery, H. ; Sangeorzan, Jon A. ; Lavery, Lawrence ; Pugh, Jacueline ; Peter-Riesch, Bettine ; Assal, Jean Phillipe ; Del Aguila, Michael ; Diehr, Paula ; Patrick, Donald L. ; Boyko, Edward J. / A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings. In: Journal of Rehabilitation Research and Development. 2001 ; Vol. 38, No. 3. pp. 309-317.
@article{ff771a68851b4cfe81dc1409fb1e801e,
title = "A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings",
abstract = "Objective: To compare patients with diabetes and new onset foot ulcers treated in Veterans Health Administration (VHA) and non-VHA settings. Methods: The treatment of patients with new onset diabetic foot ulcers was prospectively monitored in three VHA and three non-VHA hospitals and outpatient settings until ulcer healing, amputation, or death. Results: Of the 302 individuals enrolled in this study, 47{\%} were veterans receiving VHA care. There were no significant differences between veterans and nonveterans in baseline wound classification, diabetes severity, or comorbid conditions. Veterans received significantly fewer sharp debridements, total contact casts, and custom inserts than their nonveteran counterparts, and they had significantly more x-rays, local saline irrigations, IV antibiotics, and prescriptions for bed rest. The percentage of amputations was higher in veterans but did not achieve statistical significance. Conclusions: Many commonly held stereotypes of veteran men were not found. Veterans and nonveterans with foot ulcers were similar in terms of health and foot history, diabetes severity, and comorbid conditions. There was considerable variation in treatment of diabetic foot ulcers between VHA and non-VHA care. Yet this variation did not result in statistically significant differences in ulcer outcomes.",
keywords = "Amputation, Diabetes mellitus, Diabetic foot, Foot ulcers, Treatment, Wound healing",
author = "Reiber, {Gayle E.} and Smith, {Douglas G.} and Janette Carter and Greg Fotieo and {Gunner Deery}, H. and Sangeorzan, {Jon A.} and Lawrence Lavery and Jacueline Pugh and Bettine Peter-Riesch and Assal, {Jean Phillipe} and {Del Aguila}, Michael and Paula Diehr and Patrick, {Donald L.} and Boyko, {Edward J.}",
year = "2001",
language = "English (US)",
volume = "38",
pages = "309--317",
journal = "Journal of rehabilitation R&D",
issn = "0748-7711",
publisher = "Rehabilitation Research and Development Service",
number = "3",

}

TY - JOUR

T1 - A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings

AU - Reiber, Gayle E.

AU - Smith, Douglas G.

AU - Carter, Janette

AU - Fotieo, Greg

AU - Gunner Deery, H.

AU - Sangeorzan, Jon A.

AU - Lavery, Lawrence

AU - Pugh, Jacueline

AU - Peter-Riesch, Bettine

AU - Assal, Jean Phillipe

AU - Del Aguila, Michael

AU - Diehr, Paula

AU - Patrick, Donald L.

AU - Boyko, Edward J.

PY - 2001

Y1 - 2001

N2 - Objective: To compare patients with diabetes and new onset foot ulcers treated in Veterans Health Administration (VHA) and non-VHA settings. Methods: The treatment of patients with new onset diabetic foot ulcers was prospectively monitored in three VHA and three non-VHA hospitals and outpatient settings until ulcer healing, amputation, or death. Results: Of the 302 individuals enrolled in this study, 47% were veterans receiving VHA care. There were no significant differences between veterans and nonveterans in baseline wound classification, diabetes severity, or comorbid conditions. Veterans received significantly fewer sharp debridements, total contact casts, and custom inserts than their nonveteran counterparts, and they had significantly more x-rays, local saline irrigations, IV antibiotics, and prescriptions for bed rest. The percentage of amputations was higher in veterans but did not achieve statistical significance. Conclusions: Many commonly held stereotypes of veteran men were not found. Veterans and nonveterans with foot ulcers were similar in terms of health and foot history, diabetes severity, and comorbid conditions. There was considerable variation in treatment of diabetic foot ulcers between VHA and non-VHA care. Yet this variation did not result in statistically significant differences in ulcer outcomes.

AB - Objective: To compare patients with diabetes and new onset foot ulcers treated in Veterans Health Administration (VHA) and non-VHA settings. Methods: The treatment of patients with new onset diabetic foot ulcers was prospectively monitored in three VHA and three non-VHA hospitals and outpatient settings until ulcer healing, amputation, or death. Results: Of the 302 individuals enrolled in this study, 47% were veterans receiving VHA care. There were no significant differences between veterans and nonveterans in baseline wound classification, diabetes severity, or comorbid conditions. Veterans received significantly fewer sharp debridements, total contact casts, and custom inserts than their nonveteran counterparts, and they had significantly more x-rays, local saline irrigations, IV antibiotics, and prescriptions for bed rest. The percentage of amputations was higher in veterans but did not achieve statistical significance. Conclusions: Many commonly held stereotypes of veteran men were not found. Veterans and nonveterans with foot ulcers were similar in terms of health and foot history, diabetes severity, and comorbid conditions. There was considerable variation in treatment of diabetic foot ulcers between VHA and non-VHA care. Yet this variation did not result in statistically significant differences in ulcer outcomes.

KW - Amputation

KW - Diabetes mellitus

KW - Diabetic foot

KW - Foot ulcers

KW - Treatment

KW - Wound healing

UR - http://www.scopus.com/inward/record.url?scp=0035707490&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035707490&partnerID=8YFLogxK

M3 - Article

C2 - 11440262

AN - SCOPUS:0035707490

VL - 38

SP - 309

EP - 317

JO - Journal of rehabilitation R&D

JF - Journal of rehabilitation R&D

SN - 0748-7711

IS - 3

ER -