Preventing nontraumatic lower extremity amputations in racial and ethnic minorities and low-income populations with diabetes is a national priority. Though patient-centered multidisciplinary approaches to treating diabetic foot wounds have been shown to reduce amputation rates, the current state of diabetic foot care is often fragmented. As a result, such programs are challenging to implement, particularly in healthcare systems that manage a diverse population of working poor and indigent patients on a fixed global budget. A significant gap exists in the ability to deliver the desired level of care to the people most in need. Therefore, our objective is to compare the delivery of multidisciplinary care through a centralized tertiary care facility to the same level of care provided through a network of community clinics using a risk-stratification system. We will partner with Harris Health, the healthcare system that provides care to the underserved throughout Harris County, the most populous county in Texas.
In this Pipeline to Proposal Independent Tier III project, we aim to strengthen and expand our existing patient and stakeholder partnerships as we collaboratively refine our research question, identify the outcomes that matter most to our patients, characterize healthcare delivery preferences within the community, and delineate the barriers that patients and their caregivers encounter when seeking care. By engaging our partners through a series of focus groups, this project will allow us to develop a patient-centered outcomes research proposal that will be directly relevant and meaningful to our patients and the rest of our community.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.