Focus on Inequalities in Diabetic Foot Infections: Highlighting the Struggles and Solutions for Unequal Access to Care
In the realm of healthcare, ensuring equitable access to services is paramount. According to Dr. Alexandra Yamshchikov, a UR Medicine Infectious Diseases physician, clinicians play a crucial role in this endeavour, particularly when it comes to patients with diabetic foot ulcers (DFUs).
Research indicates that Black patients with DFUs tend to present with more severe disease and experience higher amputation rates compared to their white counterparts. This disparity is not limited to DFUs; Black populations often face worse outcomes in diabetic complications, due in part to delayed treatment and limited access to specialized care.
Black patients with DFUs often present with more advanced or complicated ulcers, which may reflect disparities in early access to care, socio-economic factors, or differences in underlying comorbidities. Infections complicate about 40% of all DFUs, and national studies suggest that Black patients may be more likely to undergo primary amputation rather than revascularization or limb-sparing procedures.
One potential solution, as proposed by Dr. Yamshchikov, is the accurate documentation of race and ethnicity data. This data provides opportunities for clinical providers and staff to examine these differences with an equity lens. By de-aggregating data by race and ethnicity, areas where interventions may be needed can be identified.
The UR Medicine Vascular Surgery division is part of the regional and national Vascular Quality Initiative (VQI) network, and members of the Vascular Surgery and Infectious Diseases divisions are exploring race and ethnicity data in relation to treatment and clinical outcomes for patients with DFUs.
Dr. Yamshchikov emphasizes the importance of focusing on clinician-patient interactions as a key to addressing disparities in treatment and outcomes for patients with DFUs. By standardizing processes and using data effectively, healthcare providers can work towards a more equitable system.
The exploration of race and ethnicity data in relation to treatment and outcomes for patients with DFUs continues at UR Medicine. While more research is needed to fully understand the complex interplay of healthcare access, systemic inequities, and differential treatment within care settings, the focus on data and interventions is a promising step towards addressing these disparities.
[1] Thrombolytic Therapy and Thrombectomy Rates in Black Patients with Acute Ischemic Stroke
[2] Racial Disparities in Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-analysis
[3] Socioeconomic Factors and Diabetes Control: A Systematic Review
[4] Racial and Ethnic Disparities in Diabetic Foot Ulcer Care: A Systematic Review
[5] Housing and Health: The Impact of Homelessness on Diabetes
- To reduce disparities in healthcare, a comprehensive approach is necessary, addressing not only medical-conditions like chronic diseases such as diabetic foot ulcers (DFUs) but also extending to health-and-wellness aspects like fitness-and-exercise, mental-health, and nutrition.
- In the case of DFUs, research indicates that Black patients often have more severe diseases and undergo higher amputation rates, highlighting the need for equitable access to services and specialized care. This pattern is not unique to DFUs, with Black populations often facing worse outcomes in other chronic diseases as well.
- To tackle these disparities, it's essential to focus on data collection, particularly accurate documentation of race and ethnicity data, which can help identify areas where interventions are needed. This information can lead to more informed decisions in health-and-wellness management and ultimately contribute to a more equitable healthcare system.
