Table 2.
Characteristics of study population stratified by racial and ethnic groups
| White (n=72 219) |
African American (n=13 279) |
Hispanic (n=3039) |
Native American (n=611) |
Other (n=3781) |
|
| Demographics | |||||
| Age, mean (SD) | 72.6 (11.5) | 68.6 (12.8) | 69.7 (14.1) | 66.6 (12.4) | 71.7 (11.4) |
| Age group | |||||
| <65 years | 16 140 (22.4) | 4907 (37.0) | 992 (32.6) | 250 (40.9) | 923 (24.4) |
| ≥65 years | 56 079 (77.7) | 8372 (63.1) | 3264 (67.4) | 361 (59.1) | 2858 (75.6) |
| Gender | |||||
| Male | 33 673 (46.6) | 5310 (40.0) | 1386 (45.6) | 269 (44.0) | 1870 (49.5) |
| Female | 38 546 (53.4) | 7969 (60.0) | 1653 (54.4) | 342 (56.0) | 1911 (50.5) |
| Socioeconomic factor | |||||
| Disability | 20 204 (28.0) | 6188 (46.6) | 1155 (38.0) | 313 (51.2) | 823 (21.8) |
| Low income subsidy | 42 543 (58.9) | 10 377 (78.2) | 2741 (90.2) | 506 (82.8) | 2896 (76.6) |
| Country residence | |||||
| Metropolitan | 57 807 (80.0) | 11 717 (88.2) | 2840 (93.5) | 298 (48.8) | 3586 (94.8) |
| Non-metropolitan | 14 312 (19.8) | 1542 (11.6) | 188 (6.2) | 309 (50.9) | 183 (4.9) |
| Unknown | 100 (0.1) | 20 (0.2) | 11 (0.4) | 4 (0.7) | 12 (0.3) |
| Median income | |||||
| Q1 | 17 480 (24.2) | 4267 (32.1) | 996 (32.8) | 287 (47.0) | 323 (8.5) |
| Q2 | 18 744 (26.0) | 3279 (24.7) | 472 (15.5) | 180 (29.5) | 668 (17.7) |
| Q3 | 17 481 (24.2) | 3142 (23.7) | 985 (32.4) | 80 (13.1) | 1375 (36.4) |
| Q4 | 18 514 (25.6) | 2591 (19.5) | 586 (19.3) | 64 (10.5) | 1415 (37.4) |
| Poverty | |||||
| <20% | 58 894 (81.6) | 8752 (65.9) | 1891 (62.2) | 349 (57.1) | 3251 (86.0) |
| ≥20% | 13 325 (18.5) | 4527 (34.1) | 1148 (37.8) | 262 (42.9) | 530 (14.0) |
| Low income subsidy | 42 543 (58.9) | 10 377 (78.2) | 2741 (90.2) | 506 (82.8) | 2896 (76.6) |
| Medical history | |||||
| ESRD | 1191 (1.7) | 843 (6.4) | 177 (5.8) | 61 (10) | 176 (4.7) |
| PAD | 38 105 (52.8) | 7943 (59.8) | 1658 (54.6) | 352 (57.6) | 1716 (45.4) |
| Insulin | 10 328 (14.3) | 2835 (21.4) | 738 (24.3) | 157 (25.7) | 614 (16.2) |
| Elixhauser comorbidity index, mean (SD) (range 0–29) | 3.8 (2.8) | 4.4 (3.2) | 3.9 (2.8) | 4.0 (3.0) | 3.5 (2.7) |
| DCSI, mean (SD) (range 0–13) | 2.1 (1.3) | 2.4 (1.4) | 2.3 (1.4) | 2.2 (1.5) | 2.1 (1.3) |
| Index diagnosis | |||||
| DFU | 13 726 (19.0) | 1963 (14.8) | 319 (10.5) | 119 (19.5) | 496 (13.1) |
| DFI | 58 493 (81.0) | 11 316 (85.2) | 2720 (89.5) | 492 (80.5) | 3285 (86.9) |
| Specialty for DFU/DFI diagnosis | |||||
| Primary care | 8367 (11.6) | 1406 (10.6) | 389 (12.8) | 95 (15.6) | 549 (14.5) |
| Podiatry | 16 405 (22.7) | 2748 (20.7) | 628 (20.7) | 69 (11.3) | 775 (20.5) |
| Specialist | 47 447 (65.7) | 9125 (68.7) | 2022 (66.5) | 447 (73.2) | 2457 (65) |
| Place of DFU/DFI diagnosis | |||||
| Hospital | 4098 (5.7) | 1041 (7.8) | 174 (5.7) | 57 (9.3) | 172 (4.6) |
| Outpatient | 10 632 (14.7) | 1797 (13.5) | 328 (10.8) | 253 (41.4) | 370 (9.8) |
| ED | 809 (1.1) | 213 (1.6) | 44 (1.5) | 17 (2.8) | 42 (1.1) |
| Home health agency | 476 (0.7) | 85 (0.6) | 26 (0.9) | 1 (0.2) | 18 (0.5) |
| Skilled nursing facility | 1628 (2.3) | 363 (2.7) | 51 (1.7) | 8 (1.3) | 82 (2.2) |
| Other | 54 576 (75.6) | 9780 (73.7) | 2416 (79.5) | 275 (45.0) | 3097 (81.9) |
| Early PCP follow-up (30 days after diagnosis) | 35 242 (48.8) | 6742 (50.8) | 1523 (50.1) | 328 (53.7) | 1892 (50.0) |
| Revascularization within 12 months | 5499 (7.6) | 1899 (14.3) | 345 (11.4) | 101 (16.5) | 334 (8.8) |
| Healthcare utilization after DFU/DFI diagnosis | |||||
| ED visits per person, mean (SD) | 0.02 (0.2) | 0.03 (0.2) | 0.03 (0.2) | 0.03 (0.2) | 0.01 (0.1) |
| Outpatient visits per person, mean (SD) | 1.59 | 2.25 | 2.39 | 2.23 | 1 |
| Inpatient hospital stay per person, mean (SD) | 13.93 (27.6) | 19.26 (28.7) | 15.4 (21.6) | 15.65 (26.95) | 15.65 (27.0) |
| Number of major amputations | 1068 (1.5) | 507 (3.8) | 64 (2.1) | 31 (5.1) | 56 (1.5) |
| Unadjusted risks of major amputation | Reference | HR=2.65, 95% CI=2.38 to 2.94, p<0.0001 | HR=1.41, 95% CI=1.10 to 1.82, p=0.0007 | HR=3.62, 95% CI=2.53 to 5.17, p<0.0001 | HR-1.00, 95% CI=0.77 to 1.31, p=0.98 |
Values are reported as number (%) unless otherwise specified.
DCSI, Diabetes Complications Severity Index; DFI, diabetic foot infection; DFU, diabetic foot ulcer; ED, emergency room; ESRD, end-stage renal disease; PAD, peripheral artery disease; PCP, primary care physician; Q, quartile.