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Foot Care For Patients With Diabetes And Additional Risk Factors For Amputation

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Veterans Affairs Office of Inspector General (OIG) sent this bulletin at 01/17/2013 03:05 PM EST

Healthcare Inspection

Foot Care for Patients with Diabetes and Additional Risk Factors for Amputation

01/16/2013 07:00 PM EST

The VA Office of Inspector General Office of Healthcare Inspections assessed

whether patients with diabetes mellitus and additional risk factors for lower

extremity amputation received annual foot care in accordance with Veterans

Health Administration (VHA) requirements.

The study population consisted of

patients with a diagnosis of diabetes mellitus and one or more of the following

risk factors for amputation during July 1, 2009February 28, 2010: peripheral

vascular disease, peripheral neuropathy, and Charcot joint disease with foot

deformity.

We used a two-stage approach to evaluate the annual rate of patient

encounters with VA or fee-basis foot care specialists.

We first examined administrative data for evidence of specialized foot care and

then conducted a focused electronic health records review of a randomly selected sample of patients for whom there was no evidence of annual care in

administrative data.

We estimated the VHA compliance rate for annual foot care

in this population at increased risk to be 66.2 percent, and we are 95 percent

confident that the actual compliance rate is between 64.95 and 67.49 percent.

We recommended and the Under Secretary for Health agreed to implement a plan

to ensure compliance with VHAs requirement that patients who are at increased

risk for amputation be examined by a foot care specialist at least

once each year.

LINK:

http://content.govdelivery.com/bulletins/gd/USVAOIG-678479

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