IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0134914.html
   My bibliography  Save this article

A Diabetic Emergency One Million Feet Long: Disparities and Burdens of Illness among Diabetic Foot Ulcer Cases within Emergency Departments in the United States, 2006–2010

Author

Listed:
  • Grant H Skrepnek
  • Joseph L Mills Sr
  • David G Armstrong

Abstract

Objectives: To evaluate the magnitude and impact of diabetic foot ulcers (DFUs) in emergency department (ED) settings from 2006–2010 in the United States (US). Methods: This cross-sectional study utilized Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) National Emergency Department Sample (NEDS) discharge records of ED cases among persons ≥18 years with any-listed diagnosis of DFUs. Multivariable analyses were conducted for clinical outcomes of patient disposition from the ED and economic outcomes of charges and lengths of stay based upon patient demographic and socioeconomic factors, hospital characteristics, and comorbid disease states. Results: Overall, 1,019,861 cases of diabetic foot complications presented to EDs in the US from 2006–2010, comprising 1.9% of the 54.2 million total diabetes cases. The mean patient age was 62.5 years and 59.4% were men. The national bill was $1.9 billion per year in the ED and $8.78 billion per year (US$ 2014) including inpatient charges among the 81.2% of cases that were admitted. Clinical outcomes included mortality in 2.0%, sepsis in 9.6% of cases and amputation in 10.5% (major-minor amputation ratio of 0.46). Multivariable analyses found that those residing in non-urban locations were associated with +51.3%, +14.9%, and +41.4% higher odds of major amputation, minor amputation, and inpatient death, respectively (p

Suggested Citation

  • Grant H Skrepnek & Joseph L Mills Sr & David G Armstrong, 2015. "A Diabetic Emergency One Million Feet Long: Disparities and Burdens of Illness among Diabetic Foot Ulcer Cases within Emergency Departments in the United States, 2006–2010," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-15, August.
    • Handle: RePEc:plo:pone00:0134914
    DOI: 10.1371/journal.pone.0134914
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134914
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0134914&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0134914?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Gaskin, D.J. & Thorpe, R.J., Jr. & McGinty, E.E. & Bower, K. & Rohde, C. & Young, J.H. & LaVeist, T.A. & Dubay, L., 2014. "Disparities in diabetes: The nexus of race, poverty, and place," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 2147-2155.
    2. Shi, L. & Forrest, C.B. & Von Schrader, S. & Ng, J., 2003. "Vulnerability and the patient-practitioner relationship: The roles of gatekeeping and primary care performance," American Journal of Public Health, American Public Health Association, vol. 93(1), pages 138-144.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ché Matthew Harris & Aiham Albaeni & Roland J Thorpe & Keith C Norris & Marwan S Abougergi, 2019. "Racial factors and inpatient outcomes among patients with diabetes hospitalized with foot ulcers and foot infections, 2003-2014," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-12, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Yanrong Qiu & Kaihuai Liao & Yanting Zou & Gengzhi Huang, 2022. "A Bibliometric Analysis on Research Regarding Residential Segregation and Health Based on CiteSpace," IJERPH, MDPI, vol. 19(16), pages 1-21, August.
    2. Thorsen, Maggie & McGarvey, Ronald & Thorsen, Andreas, 2020. "Diabetes management at community health centers: Examining associations with patient and regional characteristics, efficiency, and staffing patterns," Social Science & Medicine, Elsevier, vol. 255(C).
    3. Shervin Assari & Maryam Moghani Lankarani, 2018. "Educational Attainment Promotes Fruit and Vegetable Intake for Whites but Not Blacks," J, MDPI, vol. 1(1), pages 1-13, June.
    4. Caitlin Brown & Martin Ravallion, 2023. "Inequality and Social Distancing during the Pandemic," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 21(3), pages 679-702, September.
    5. Judith M. Ochieng & Janice D. Crist, 2021. "Social Determinants of Health and Health Care Delivery: African American Women’s T2DM Self-Management," Clinical Nursing Research, , vol. 30(3), pages 263-272, March.
    6. Barber, Sharrelle & Diez Roux, Ana V. & Cardoso, Letícia & Santos, Simone & Toste, Veronica & James, Sherman & Barreto, Sandhi & Schmidt, Maria & Giatti, Luana & Chor, Dora, 2018. "At the intersection of place, race, and health in Brazil: Residential segregation and cardio-metabolic risk factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)," Social Science & Medicine, Elsevier, vol. 199(C), pages 67-76.
    7. Ifechukwude Obiamaka Okwechime & Shamarial Roberson & Agricola Odoi, 2015. "Prevalence and Predictors of Pre-Diabetes and Diabetes among Adults 18 Years or Older in Florida: A Multinomial Logistic Modeling Approach," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-17, December.
    8. Jean R. Francois & Katherine S. Nelson & Emily K. Burchfield, 2024. "Linking Diversity–Productivity Conditions of Farming Systems with the Well-Being of Agricultural Communities," Sustainability, MDPI, vol. 16(16), pages 1-16, August.
    9. Do, D. Phuong & Frank, Reanne & Iceland, John, 2017. "Black-white metropolitan segregation and self-rated health: Investigating the role of neighborhood poverty," Social Science & Medicine, Elsevier, vol. 187(C), pages 85-92.
    10. Laura E. Wild & McKailey Walters & Alaina Powell & Katherine A. James & Laura Corlin & Tanya L. Alderete, 2022. "County-Level Social Vulnerability Is Positively Associated with Cardiometabolic Disease in Colorado," IJERPH, MDPI, vol. 19(4), pages 1-14, February.
    11. Wang, Yingli & Touboulic, Anne & O'Neill, Martin, 2018. "An exploration of solutions for improving access to affordable fresh food with disadvantaged Welsh communities," European Journal of Operational Research, Elsevier, vol. 268(3), pages 1021-1039.
    12. Samuel D. Towne & Jane Bolin & Alva Ferdinand & Emily Joy Nicklett & Matthew Lee Smith & Marcia G. Ory, 2017. "Assessing Diabetes and Factors Associated with Foregoing Medical Care among Persons with Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in," IJERPH, MDPI, vol. 14(5), pages 1-17, April.
    13. Diana‐Lyn Baptiste, 2018. "Who you are and where you live can determine how long you live: What nurses need to know about cardiovascular disease among low‐income urban‐dwelling minority communities," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3441-3442, October.
    14. Michaela Olm & Ewan Donnachie & Martin Tauscher & Roman Gerlach & Klaus Linde & Werner Maier & Lars Schwettmann & Antonius Schneider, 2021. "Ambulatory specialist costs and morbidity of coordinated and uncoordinated patients before and after abolition of copayment: A cohort analysis," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-14, June.
    15. Armani M. Hawes & Genee S. Smith & Emma McGinty & Caryn Bell & Kelly Bower & Thomas A. LaVeist & Darrell J. Gaskin & Roland J. Thorpe, 2019. "Disentangling Race, Poverty, and Place in Disparities in Physical Activity," IJERPH, MDPI, vol. 16(7), pages 1-12, April.
    16. Aubert, Cécile & Dang, Hai-Anh H & Nguyen, Manh-Hung, 2022. "The Unequal Impact of the COVID Pandemic: Theory and Evidence on Health and Economic Outcomes for Different Income Groups," IZA Discussion Papers 15396, Institute of Labor Economics (IZA).
    17. Iroz-Elardo, Nicole & Schoner, Jessica & Fox, Eric H. & Brookes, Allen & Frank, Lawrence D., 2020. "Active travel and social justice: Addressing disparities and promoting health equity through a novel approach to Regional Transportation Planning," Social Science & Medicine, Elsevier, vol. 261(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0134914. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.