Hanger, Austin, Texas, announced the findings of a study conducted by the Hanger Institute for Clinical Research and Education in partnership with CareJourney, a source of provider cost and quality data. The study examined the timing of lower-limb amputations between racial groups and gender for Medicare fee-for-service (FFS) beneficiaries following diabetic foot ulcers (DFU).
The study analyzed all Medicare FFS patients with DFU over a five-year period (2012 to 2017), a population of more than 640,000 patients. The results found that Black patients have 98 percent increased odds of receiving a lower-limb amputation within the first year following a DFU diagnosis compared to white beneficiaries.
In addition to racial disparities, the study also found moderate differences in care across gender for Medicare FFS patients with DFU, with females having 7-8 percent increased odds of lower-limb amputations occurring later as compared to their male counterparts.
“We’ve all observed the glaring disparities in quality outcomes by race throughout the pandemic, but these findings were an even greater shock for me,” said Aneesh Chopra, CareJourney president and former chief technology officer under President Obama. “With one out of three Medicare beneficiaries managing diabetes, it’s imperative that equitable care, driven by clinical evidence, is provided despite race, gender, or any other trait that makes an individual unique. We are grateful for our partnership with the Hanger Institute as it helped us identify these inequities that were otherwise hidden in publicly accessible CMS data.”
Diabetes affects more than 37 million people in the United States, with 25 percent of those individuals likely to experience a DFU in their lifetime.
“The first step to dismantling inequities is identifying where they are occurring,” said James Campbell, PhD, Hanger’s chief clinical officer. “This foundational work provides a springboard to address disparities and our continued efforts to understand the positive and negative impact of earlier or delayed amputation on long-term outcomes, promoting better guidance for evidence-based decision-making.”
The open-access study, “Racial disparities in health care with timing to amputation following diabetic foot ulcer,” was published in the American Diabetes Association journal Diabetes Care.
