American Diabetes Association Scientific Sessions

American Diabetes Association Scientific Sessions

Source:

Tan T 217-OR. Presented at: American Diabetes Association Scientific Sessions; June 12-16, 2020 (virtual meeting).

Disclosures: Tan reports no relevant financial disclosures.
June 15, 2020
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Medicaid expansion yields ‘positive effects’ on diabetic foot ulcer care for US minorities

Source:

Tan T 217-OR. Presented at: American Diabetes Association Scientific Sessions; June 12-16, 2020 (virtual meeting).

Disclosures: Tan reports no relevant financial disclosures.
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Hospital admissions for diabetic foot ulcers among nonwhite U.S. residents with Medicaid coverage nearly doubled in states that were early adopters of Affordable Care Act expansion programs, according to study data.

In addition, major amputations, defined as at the ankle or above, dropped by more than 17%, Tze-Woei Tan, MD, MPH, FACS, associate professor in the division of vascular surgery at the University of Arizona, said during a presentation at the American Diabetes Association Scientific Sessions.

Diabetic Foot Ulcer 2019
Source: Adobe Stock

“Diabetic foot ulcerations and leg amputations are significant and costly public health problems,” Tan told Healio. “Racial and ethnic minorities ... have significantly higher risks of diabetic foot ulcerations and amputations than whites. Race/ethnicity and insurance status are independent risk factors of amputations in diabetes.”

Tze-Woei Tan

Tan and colleagues analyzed data from 2013 to 2015 from 19 state inpatient databases on 25,493 nonwhite Medicaid beneficiaries and 9,863 uninsured patients with diabetic foot ulcers. The researchers compared data from states that adopted ACA Medicaid expansion before January 2014 — early adopter states — with nonadopter states as well as data from before and after adoption.

Among early adopter states, the researchers observed an increase of 180.7% in hospital admissions for diabetic foot ulcers among Medicaid beneficiaries and a decrease of 21.5% among uninsured patients expansion. In nonadopter states, admissions of uninsured patients increased by 78.2% during the same period.

Early adopter states also saw a 17.3% drop in the odds of major amputation among the patients with Medicaid coverage and a 14% increase in the odds of minor amputation (P = .045) vs. a 0.9% increase in major amputations and an 8.1% decrease in minor amputations in nonadopter states (P = .003).

‘The ACA Medicaid expansion has substantial positive effects on the care of minorities with diabetic foot ulcerations,” Tan said. “The broadening of ACA could reduce the disparities of diabetesrelated amputations among low-income racial/ethnic minorities with low diabetic foot ulcerations.”