FRIDAY, April 21, 2023 (HealthDay News) -- For veterans with peripheral artery disease, health care utilization, distance to primary care, and geographic region are associated with receipt of vascular assessment prior to lower-extremity amputation (LEA), according to a study published online April 19 in JAMA Surgery.
Olamide Alabi, M.D., from the Atlanta VA Healthcare System in Decatur, Georgia, and Emory Heart & Vascular Center in Atlanta, and colleagues examined the extent to which health care utilization and regional practice variation are associated with receipt of vascular assessment prior to major LEA among veterans aged 18 years or older. Data were included for 19,396 veterans (mean age, 66.78 years).
The researchers found that 8.0 and 30.1 percent of veterans had no primary care visits and did not have a vascular assessment, respectively, in the year prior to LEA. Veterans with fewer than four primary care clinic visits were less likely than those with four to 11 visits to receive vascular assessment in the year prior to LEA (one to three visits: adjusted odds ratio, 0.90). Veterans who lived 13 miles or more from the closest primary care facility were less likely to receive vascular assessment compared with those who lived less than 13 miles from the closest facility (adjusted odds ratio, 0.88). The likelihood of undergoing vascular assessment in the year prior to LEA was highest for veterans who lived in the Midwest versus those living in other regions.
"The findings suggest the need for interventions focused on establishing earlier diagnosis of peripheral artery disease and prompting referral to vascular surgeons," the authors write.
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