Disease management for the diabetic foot: Effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations

Lawrence A. Lavery, Robert P. Wunderlich, Jeffrey L. Tredwell

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Objective: To demonstrate the effectiveness of a diabetic foot disease management program in a managed care organization. Methods: We implemented a lower extremity disease management program consisting of screening and treatment protocols for diabetic members in a managed care organization. Screening consisted of evaluation of neuropathy, peripheral vascular disease, deformities, foot pressures, and history of lower extremity pathology. We stratified patients into low and high-risk groups, and implemented preventive or acute care protocols. Utilization was tracked for 28 months and compared to 12 months of historic data prior to implementation of the disease management program. Results: After we implemented the disease management program, the incidence of amputations decreased 47.4% from 12.89 per 1000 diabetics per year to 6.18 (p < 0.05). The number of foot-related hospital admissions decreased 37.8% from 22.86 per 1000 members per year to 14.23 (37.8%). The average inpatient length-of-stay (LOS) was reduced 21.7% from 4.75 to 3.72 days (p < 0.05). In addition, there was a 69.8% reduction in the number of skilled nursing facility (SNF) admissions per 1000 members per year (Table 1) and a 38.2% reduction in the average SNF LOS from 8.72 to 6.52 days (p < 0.05). Conclusion: A population-based screening and treatment program for the diabetic foot can dramatically reduce hospitalizations and clinical outcomes.

Original languageEnglish (US)
Pages (from-to)31-37
Number of pages7
JournalDiabetes Research and Clinical Practice
Volume70
Issue number1
DOIs
StatePublished - Oct 2005

Fingerprint

Diabetic Foot
Disease Management
Amputation
Hospitalization
Skilled Nursing Facilities
Managed Care Programs
Lower Extremity
Length of Stay
Foot Diseases
Organizations
Foot Deformities
Peripheral Vascular Diseases
Clinical Protocols
Foot
Inpatients
Pathology
Pressure
Incidence
Population
Therapeutics

Keywords

  • Amputation
  • Diabetes
  • Foot
  • Infection
  • Prevention
  • Ulcer

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Disease management for the diabetic foot : Effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations. / Lavery, Lawrence A.; Wunderlich, Robert P.; Tredwell, Jeffrey L.

In: Diabetes Research and Clinical Practice, Vol. 70, No. 1, 10.2005, p. 31-37.

Research output: Contribution to journalArticle

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