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Diabetic foot care and lower limb preservation: Evolving a value-based health care initiative in Ontario

Foot and wound care for patients with diabetes is unnecessarily costing the health care system in Ontario millions of dollars. Interprofessional knowledge is lacking in specific clinical and support roles and skills. These roles are fulfilled by foot and wound care teams who support appropriate, safe, and excellent care.

What are the recommended actions that could help alleviate this cost? What are the main barriers to foot and wound care in Ontario? Thirty-seven individuals participated in patient and clinical site forums, and leaders from two clinical sites completed pre-forum questionnaires. What were the main messages advocated by these participants?

This issue briefing examines the contextual specifics of the diabetes foot care and limb preservation (DFCLP) pathway components, providers, and care settings involved, and the patient populations they serve.

Young woman making foot massage on sofa

Key Insights

Timely and affordable access to skilled healthcare professionals and community-based services remains a major barrier for many Canadians with diabetic foot complications. Not enough preventative care is available to reduce otherwise avoidable ulcerations and limb amputations.

Systemic inequity is resulting in individuals receiving uneven access to care and delayed treatment. Patients without private insurance coverage and without access to foot specialists in community-based primary care are more likely to develop ulcerations. Embed a value-based healthcare approach and fund preventative services to reduce Ontario’s rate of lower limb amputations due to diabetic foot ulcerations.

The foot and wound care pathway in Ontario is siloed, with gaps in funding, data collection, and sharing. Increase the use of system-wide and standardized data collection tools and instruments.

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