关键词：糖尿病;脚截肢;预防医学;健康教育;诊断;患者;危险因素;医院
摘 要：The VA Office of Inspector General Office of Healthcare Inspections assessed whether patients with diabetes mellitus and additional risk factors for lower extremity amputation received annual foot care in accordance with Veterans Health Administration (VHA) requirements. The study population consisted of patients with a diagnosis of diabetes mellitus and one or more of the following risk factors for amputation during July 1, 2009-February 28, 2010: peripheral vascular disease, peripheral neuropathy, and Charcot joint disease with foot deformity. We used a two-stage approach to evaluate the annual rate of patient encounters with VA or fee basis foot care specialists. We first examined administrative data for evidence of specialized foot care and then conducted a focused electronic health record review of a randomly selected sample of patients for whom there was no evidence of annual care in administrative data.