Recorded presentation

Aelia Akhtar, MS¹, Graciela Castillo, MPH¹, Susan Fenton, MBA, RHIA¹, Jay Jezierski, MPH², Bita Kash, MBA¹, Margaret Kriegel, MSN, RN, CNS¹, Lesley Magnussen, MPH¹, Patricia Moore, MEd¹, and Martha Conkling Tromp, MSPH¹. (1) Health Policy and Management, Texas A&M University School of Rural Public Health, 3000 Briarcrest Dr., Ste. 300, Bryan, TX 77802, 979-458-3031, mctromp@srph.tamushsc.edu, (2) Community Health Development Program, School of Rural Public Health, Texas A&M University, 1103 University Drive, Suite 100, College Station, TX 77840

PURPOSE: To explain the repercussions of the 2003 Medicaid cuts for diabetics needing podiatric foot care. There are 1.06 million people with diabetes in Texas which is the State’s fifth leading cause of death. Healthcare costs for diabetics in Texas are over $5 billion each year. Lower leg amputations are expected for 8000 diabetic Texans this year at a cost of $210 million. METHODS: In the interest of doing practical work in an academic setting, a PhD health policy class examined this issue. Research was undertaken to describe the problem facing Texas by examining legislative actions, costs of and populations affected by diabetes, clinical problems associated with diabetes, and a policy strategy to appropriately deal with the findings. RESULTS: The elderly in Texas and Texans of Hispanic and African-American origin are disadvantaged by the elimination of podiatric foot care. The prevalence of diabetes among adults aged 65-74 is 13 times higher than that for people aged 45. Diabetics have a 15% chance of developing a foot ulcer. Of these people, 25% will have an amputation. Up to 85% of these amputations can be prevented with appropriate medical care. The chance of another amputation within 5 years is as high as 50%. The risk of dying within 5 years of an amputation ranges from 39-68%. Appropriate foot care for diabetics could save Texas $100 million in healthcare costs. The indirect costs of diabetes due to disability, work loss and premature mortality are estimated to exceed $2 billion annually in Texas.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Discuss the importance of continuity of care for diabetic patients.
• Describe the process of sharing academic information for policy making at the state level.
• Discuss the costs involved with diabetic neuropathy leading to amputation.

Keywords: Policy/Policy Development, Diabetes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation