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Initial nontraumatic lower-extremity amputations among veterans with diabetes
Usha Sambamoorthi1, Chin-Lin Tseng, Mangala Rajan
1HSR&D Center for Health Care Knowledge and Management, VA New Jersey Health Care System, East Orange, New Jersey, USA. usha@njneuromed.org
Medical Care
|July 25, 2006
Summary
Identifying initial nontraumatic lower-extremity amputations (ILEAs) is crucial for veterans with diabetes. A 24-month look-back period using administrative data provided the most complete identification of ILEAs, aiding in trend analysis.
Area of Science:
- Health Services Research
- Epidemiology
- Diabetes Complications Research
Background:
- Initial nontraumatic lower-extremity amputations (ILEAs) are a significant concern for veterans with diabetes.
- Accurate identification of ILEAs is essential for monitoring trends and disparities in care.
Purpose of the Study:
- To identify ILEAs in veterans with diabetes using administrative data.
- To compare the effectiveness of different coding algorithms and look-back periods for ILEA identification.
Main Methods:
- Retrospective analysis of merged Medicare claims and Veteran Healthcare Administration data (FY 1998-2000).
- Utilized three algorithms with varying inclusivity of procedure codes.
- Employed look-back periods of 12, 18, and 24 months to identify ILEAs.
Main Results:
- In FY 2000, 2997 (8.2 per 1000) veterans experienced amputations.
- With a 24-month look-back, ILEA rates ranged from 6.0 to 6.4 per 1000 across algorithms.
- Longer look-back periods (12, 18, 24 months) decreased ILEA rates by 19%, 24%, and 27% respectively.
Conclusions:
- Administrative data are valuable for identifying ILEAs in veterans with diabetes.
- All three algorithms demonstrated comparable performance in ILEA detection.
- A 24-month look-back period offered the most comprehensive identification, with diminishing returns beyond 18 months.
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