02417nas a2200385   4500000000100000008004100001653000900042653001900051653002700070653001800097653001100115653001100126653000900137653001300146653001200159653003100171653002500202653003600227653002200263653002000285653001700305653001400322653003100336100001600367700001800383700001300401700001800414700001800432700001500450245015300465300001000618490000700628520138200635022001402017       2001                            d10aAged10aCohort Studies10aDiabetes Complications10aDiabetic Foot10aFemale10aHumans10aMale10aMedicare10aMontana10aPatient Education as Topic10aPhysical Examination10aQuality Indicators, Health Care10aRandom Allocation10aRisk Assessment10aRisk Factors10aSelf care10aSurveys and Questionnaires1 aHarwell T S1 aHelgerson S D1 aGohdes D1 aMcInerney M J1 aRoumagoux L P1 aSmilie J G00aFoot care practices, services and perceptions of risk among medicare beneficiaries with diabetes at high and low risk for future foot complications.  a734-80 v223 a<p>A cohort of Medicare beneficiaries with diabetes was identified from inpatient and outpatient claims data and their risk for foot complications was estimated based on claims reflecting services for recent foot problems. A telephone survey of a random sample from this cohort was conducted to assess their foot care practices, barriers, and perceptions of risk. Eight percent of respondents reported a history of foot ulcers and 7% a history of lower extremity amputation. Based on claims data, 30% of respondents were at high risk for future foot complications. Compared to those at low risk, those at high risk were more likely to report having an annual foot exam, using protective footwear, and perceiving themselves to be high risk for future foot complications. However, 50% of those with claims indicating a high risk perceived themselves to be at low risk for future foot complications. Overall, 20% of respondents seldom checked their feet daily for sores or irritations. Among this group, 60% felt that it was unimportant and 9% reported they were limited by poor vision or physical problems. Our findings suggest that strategies are needed to improve the delivery of preventive foot care services to older persons with diabetes. Additionally, emphasis is needed to help individuals understand their risk and seek and perform appropriate preventive foot care.</p>
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