Podiatric Consultation Impact on Health Care Utilization

How does podiatric consultation impact length of hospital stay and readmission statistics? A recent poster at the American Society of Podiatric Surgeons’ Annual Conference set out to examine this question. The authors retrospectively looked at over 300 hospitalizations for adults with lower extremity wounds over a 17-month period. They further evaluated 30-day readmissions, length of stay, presence of podiatric consultation, and other covariates.
 
The study population was mostly Caucasian (78%) with a mean age just over 62 years. Overall, the cohort experienced a 30-day readmission rate of 7.8%. Podiatric consultations took place in 46.4% of the overall cohort. Subsequently, 30-day readmission rates were 4.2% in those that received podiatric consultation and 11.3% for those without, which was statistically significant. Overall, podiatric consultation was not associated with shorter length of stay. However, this did depend on timing of consultation. When considering earlier consultation timing, lengths of stay were shorter than when consultations were placed later during the admission.
 
Zeeshan Husain, DPM, FACFAS, FASPS, one of the authors on the study, shares that he and his team aimed to demonstrate the value of podiatric surgery consults to improve quality of care and reduce health care costs.
 
“We felt our service was underutilized and relatively unknown with new leadership a few years ago,” he explains. “This research project was seen as a way to prove our value and worth to the hospital. We were pleased to show that podiatric surgery inclusion to the hospital improved length of stay and lower readmission rates for patients with lower extremity wounds.”
 
Dr. Husain encourages podiatric surgeons to work with hospital administrators and departments to show the importance of the inclusion of podiatric surgery with multidisciplinary collaboration, especially for foot and ankle pathologies.
 
“This study showed that podiatric consultations helped to decrease 30-day readmission rates 4-fold,” he says.
 
He shares plans to extend the project to the entire hospital system statewide, and to also include emergency room encounters. 
 
“We are also currently assessing outcomes of gas gangrene cases of the foot based on which service provides care, organisms identified, comorbidities, and correlation of location of soft tissue emphysema and amputation level,” he adds.