Shachar Tal, Yaacobi Eyal, Romem Roy, Fadila Mohamad, Sarrabia Geva, Saban Mor, Ohana Nissim
Affiliated with Faculty of Medicine and Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
Nursing Department, The Stanley Steyer School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
J Pers Med. 2025 Mar 29;15(4):133. doi: 10.3390/jpm15040133.
: To explore the impact of ethnic and socioeconomic disparities on diabetic foot ulcer (DFU) care and outcomes, emphasizing the need for personalized treatment approaches tailored to diverse patient populations. : This retrospective observational study analyzed 1409 patients hospitalized with DFUs between 2016 and 2023 at a tertiary medical center. Data extracted from electronic medical records included demographics, socioeconomic status (SES), clinical variables, and healthcare utilization. Statistical analyses included descriptive statistics, Chi-Square and Kruskal-Wallis tests, and a regularized logistic regression model to identify predictors of mortality and disparities in treatment access. : Arab patients had significantly lower SES (median score: 3.00) compared to Jewish patients (median score: 8.00), resulting in reduced healthcare access and worse clinical outcomes. Arab patients were diagnosed with diabetes at a younger age (57 years vs. 68 years for Jewish patients) and exhibited a higher body mass index (30.36 vs. 28.68, < 0.05). Despite similar mortality rates between groups (21.52% vs. 22.83%, = 0.65), differences in healthcare utilization were evident, particularly in younger patients (18-59 years) within the internal medicine department ( = 0.017). : Our findings underscore the need for a personalized approach to diabetic foot care, integrating socioeconomic and demographic factors into treatment plans. Ethnic minorities with lower SES, earlier diabetes onset, and higher BMI may require tailored intervention strategies to optimize prevention, access to specialized care, and adherence to treatment. Addressing individualized patient needs through precision medicine and culturally adapted healthcare models can improve outcomes and reduce disparities in DFU management.
为探讨种族和社会经济差异对糖尿病足溃疡(DFU)护理及结局的影响,强调需要针对不同患者群体制定个性化治疗方法。 这项回顾性观察性研究分析了2016年至2023年期间在一家三级医疗中心因DFU住院的1409例患者。从电子病历中提取的数据包括人口统计学、社会经济地位(SES)、临床变量和医疗保健利用情况。统计分析包括描述性统计、卡方检验和克鲁斯卡尔 - 沃利斯检验,以及一个正则化逻辑回归模型,以确定死亡率预测因素和治疗可及性差异。 与犹太患者(中位数得分:8.00)相比,阿拉伯患者的SES显著较低(中位数得分:3.00),导致医疗保健可及性降低和临床结局更差。阿拉伯患者糖尿病诊断年龄较轻(57岁,而犹太患者为68岁),且体重指数较高(30.36对28.68,<0.05)。尽管两组之间死亡率相似(21.52%对22.83%,=0.65),但医疗保健利用方面的差异很明显,尤其是在内科的年轻患者(18 - 59岁)中(=0.017)。 我们的研究结果强调了糖尿病足护理采用个性化方法的必要性,将社会经济和人口统计学因素纳入治疗计划。SES较低、糖尿病发病较早且BMI较高的少数民族可能需要量身定制的干预策略,以优化预防、获得专科护理的机会和治疗依从性。通过精准医学和文化适应的医疗保健模式满足个体化患者需求,可以改善结局并减少DFU管理中的差异。