Geographic Variation in Amputations for Medicare Patients With Diabetic Lower-Extremity Wounds
Authors' conclusion
In this cross-sectional study of Medicare beneficiaries with DLE wounds, beyond social determinants of health, higher podiatrist supply was associated with fewer amputations. These findings suggest that increasing access to podiatry may reduce amputations among patients with DLE wounds.
Study context
- Population
- Medicare fee-for-service beneficiaries aged ≥66 years with diabetic lower-extremity (DLE) wounds, 2017–2019, 306 hospital referral regions (hospital referral region (HRRs))DLE wounds in 306 HRRs
- Participants
- 707,971 beneficiaries
- Outcome
- HRR-year proportion of DLE wounds undergoing major amputation
- Follow-up
- Within 12 months after diagnosis
Methodological detailsHRR-level aggregation, spatial-temporal bayesian models
- HRR-level aggregation
- Spatial-temporal bayesian models
Main finding
As reported in the abstract
Associations of HRR-level factors with HRR-year major amputations
- Median (range) HRR-year proportion of DLE wounds followed by major amputation
- 3.0% (0.3%-9.3%)
- Percentage of Black patients, OR
- 5.19 (3.78-7.12) (95% CrI)
- Percentage of Hispanic patients, OR
- 2.39 (1.73-3.29) (95% CrI)
- Economic deprivation, OR
- 1.29 (1.02-1.62) (95% CrI)
- Podiatrist supply (only health care factor with negative association), OR
- 0.74 (0.66-0.82) (95% CrI)
- Estimated reduction in amputation odds with 1 additional podiatrist per 10 000 beneficiaries in low-, medium- and higher-supply markets (≈1, 4 and 9 per 10 000)
- 19.1%, 6.6%, and 3.2%
Observational data: associations, not effects.
Original publication
Geographic Variation in Amputations for Medicare Patients With Diabetic Lower-Extremity Wounds. JAMA Netw Open. Published 1 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →