Healthcare leaders from across the nation met in Potomac, Maryland, February 9-11, 2012, at the Amputee Coalition Limb Loss Summit to review the U.S. Department of Veterans Affairs’ (VA) Preservation Amputation Care and Treatment program (PACT), which has shown compelling outcomes in limb loss prevention. This group, comprising physicians, nurses, psychologists, prosthetists, and healthcare policy leaders from the Centers for Disease Control and Prevention (CDC), the Veterans Administration, the Agency for Healthcare Research and Quality (AHRQ), the National Institute on Disability and Rehabilitation Research (NIDRR), and civilian hospitals and healthcare systems, examined elements of the VA program to develop a limb loss prevention plan for the private sector healthcare system.
Members of the Limb Loss Task Force at work. Photograph courtesy of the Amputee Coalition.
The VA’s initiative, which began in 1992, has demonstrated a significant reduction in rates of foot ulcers from diabetes and peripheral vascular disease, which are the leading causes of amputation. For example, the Nashville VA Medical Center, Tennessee, has demonstrated a 40 percent decrease in the number of lower-limb amputations over the past five years, a reduction in the cost of pharmaceuticals by 48 percent, lab studies by 32 percent, and inpatient bed days by 44 percent.
“We agree that the VA system offers much promise if translated to the private sector healthcare system,” said Terrence Sheehan, MD, Amputee Coalition medical director and chief medical officer at Adventist Rehabilitation Hospital, Rockville, Maryland. “The next step is to create a demonstration project to test these limb-saving and cost-saving measures.”
There are approximately 507 amputations in the United States each day, and the rate will double by 2050 unless better prevention programs are instituted, according to the Limb Loss Task Force II. Those most at risk are minorities and people with diabetes and vascular disease. Over 85 percent of these amputations are preventable.
“We are pleased to share our experiences from the VA system with healthcare leaders, and we are eager to do what we can to assist the civilian healthcare system to learn from our success,” said Jeffrey Robbins, DPM, director of podiatry services, Veterans Administration, and chairman of the PACT program oversight committee.
The group concluded that the number one priority is to conduct a demonstration project in a civilian hospital, using the VA system of care. Task Force members will continue to work together to collaborate on funding, resources, and research. A full white paper from the Limb Loss Task Force II will be available by the summer of 2012.
