Association of rurality and identifying as black with receipt of specialty care among patients hospitalized with a diabetic foot ulcer: a Medicare cohort study
Authors' conclusion
A smaller proportion of rural patients, particularly those identifying as black, received specialty care when hospitalized with a diabetic foot ulcer compared with the overall cohort. This might contribute to known disparities in major amputations. Future studies are needed to determine causality.
Study context
- Population
- Medicare beneficiaries hospitalized with DFU (2013–2014), USA100% Medicare cohort
- Exposure
- Rural vs urban patients, by race
- Ruraln = 13,100
- Blackn = 21,649
- Rural blackn = 1,239
- Outcome
- Receipt of specialty care (endocrinology, infectious disease, orthopedic surgery, plastic surgery, podiatry or vascular surgery)
Methodological details100% national Medicare cohort, logistic regression with rurality × black race interaction term
- 100% national Medicare cohort
- Logistic regression with rurality × black race interaction term
Main finding
As reported in the abstract
Received specialty care
Adjusted odds ratio (95% CI)
Rural blackvs Urban black
0.61(0.53–0.71)
Rural whitevs Urban white
0.85(0.80–0.89)
Observational data: associations, not effects.
Original publication
Association of rurality and identifying as black with receipt of specialty care among patients hospitalized with a diabetic foot ulcer: a Medicare cohort study. BMJ Open Diabetes Res Care. Published 18 April 2023. doi:10.
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