Spatial associations between measures of public transportation and diabetic foot ulcer outcomes in the state of Georgia: 2016–2019
Authors' conclusion
In Georgia, public transportation reliance and availability are protective against DFU-related amputations in high-income but not among low-income ZCTAs. Reducing disparities in DFU-related amputations requires interventions to mitigate transportation barriers to care.
Study context
- Population
- Diabetic foot ulcer (DFU) visits in Georgia, 2016–2019 Healthcare Cost and Utilization Project database, analysed at ZIP code tabulation area (ZCTA) level
- Participants
- 114,606 DFUs
- Comparison
- Public transportation reliance, availability and expense vs DFU-related amputation risk
- Outcome
- DFU-related amputations
Methodological detailsBayesian spatial-temporal models, ZCTA level, stratified by poverty status quartile
- Bayesian spatial-temporal models
- ZCTA level
- Stratified by poverty status quartile
Main finding
As reported in the abstract
Highest income quartile ZCTAs: proportion of adults using public transportation to commute, RR per IQR increase of 1.13%
0.29
95% CI 0.09 to 0.97
Highest income quartile ZCTAs: per capita expense on public transportation, RR per IQR increase of 6 cents
0.78
95% CI 0.63 to 0.78
Metropolitan Georgia, lowest income quartile ZCTAs: 1 IQR (261 m) increase in distance to nearest transit stop, RR
0.47
95% CI 0.26 to 0.85
Further findings
DFUs associated with a major or minor amputation
- DFUs with major or minor amputation
- 21 388 (19%)
Original publication
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