Disease management for the diabetic foot : Effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations

Abstract Objective: To demonstrate the effectiveness of a diabetic foot disease management program in a managed care organization. Methods: We implemented a lower extremity disease management program consisting of screening and treatment protocols for diabetic members in a managed care organization. Screening consisted of evaluation of neuropathy, peripheral vascular disease, deformities, foot pressures, and history of lower extremity pathology. We stratified patients into low and high-risk groups, and implemented preventive or acute care protocols. Utilization was tracked for 28 months and compared to 12 months of historic data prior to implementation of the disease management program. Results: After we implemented the disease management program, the incidence of amputations decreased 47.4% from 12.89 per 1000 diabetics per year to 6.18 ( p p p Conclusion: A population-based screening and treatment program for the diabetic foot can dramatically reduce hospitalizations and clinical outcomes.