An organised approach to the podiatric care of people with diabetes in regional Australia

Abstract

Objective. To ensure an efficient publicly funded podiatric service for people with diabetes in regional Victoria, a Podiatry Diabetes Model (PDM) of care was developed. The aim of this study was to determine if people with diabetes attended the most appropriate podiatric service as depicted by the model. Methods. A 3-month prospective clinical audit of the PDM was undertaken. Primary variables of interest were the podiatric service where the patients were seen and the patients’ risk of future foot morbidity. Chi-square analyses for each service category were undertaken to compare the expected number of patients seen according to foot-health risk as predicted by the model, with what was observed. Results. Five hundred and seventy-six people with diabetes were seen in the 3-month period. There was no statistically significant difference between the proportion of patients seen by each podiatric service according to risk status, with what was expected (community: χ2 = 3.3, P = 0.4; subacute: χ2 = 8.0, P = 0.05; acute: χ2 = 6.6, P = 0.09). Conclusions. The Podiatry Diabetes Model is a sound podiatric model of care and is an example of cross-organisational collaboration that could be implemented in other areas of Australia. What is known about the topic? Diabetes-related foot complications are a significant burden on health systems and individuals with diabetes. Podiatric services are important in the prevention and management of complications such as peripheral neuropathy, ulceration and lower limb amputation. It is important to organise healthcare systems to ensure appropriate and efficient services are provided for people with diabetes. What does this paper add? This paper describes and tests a novel collaborative, multi-organisation podiatric model of care for people with diabetes in a large regional Australian setting. What are the implications for practitioners? This paper demonstrates that it is possible to collaborate across multiple organisations to provide a comprehensive publicly funded podiatric service to people with diabetes that encompasses the entire risk spectrum for future diabetes-related foot complications.