{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T04:06:21Z","timestamp":1773115581380,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The link between social deprivation and the development of diabetic foot ulcer (DFU) is still widely debated. The study objective was to evaluate the relationship between lower limb amputation, social deprivation level, and inequalities in access to care service among people with DFU. This regional pilot study was conducted at the living area level and based on the French National Health Data System (SNDS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study using hospital and primary care claim data in the Languedoc\u2010Roussillon region. DFUs were determined using an original algorithm of care consumption or hospital diagnosis. The primary end point was amputation at 1\u00a0year. Secondary end points were mortality at 1\u00a0year and impact of potential access to care on amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 15,507 people from 2015 to 2017. Amputation and mortality rates were 17.5 and 117 per 1000 person\u2010years. The least precarious living areas showed better prognoses (relative risk\u00a0=\u00a00.46; 95% CI 0.27\u20130.66). Territorial accessibility to a private\u2010practice nurse, unlike physician accessibility, was associated with better results on major outcomes (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study using SNDS to study the care pathway of DFU management within and outside the hospital. High social deprivation in a living areas seems to be associated with more major amputations after a DFU.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14820","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T16:16:56Z","timestamp":1645719416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effects of social deprivation and healthcare access on major amputation following a diabetic foot ulcer in a French administrative area: Analysis using the French claim data"],"prefix":"10.1111","volume":"39","author":[{"given":"Jean\u2010Baptiste","family":"Bonnet","sequence":"first","affiliation":[{"name":"UMR 1302, Institute Desbrest of Epidemiology and Public Health, INSERM, CHU University of Montpellier  Montpellier France"},{"name":"Endocrinology\u2010Diabetes\u2010Nutrition Department, CHU Montpellier University of Montpellier  Montpellier France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Nicolet","sequence":"additional","affiliation":[{"name":"Clinical Research and Epidemiology Unit, CHU Montpellier University of Montpellier  Montpellier France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Papinaud","sequence":"additional","affiliation":[{"name":"Information Systems Unit at the Regional Medical Office of the Assurance Maladie  Montpellier France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Avignon","sequence":"additional","affiliation":[{"name":"UMR 1302, Institute Desbrest of Epidemiology and Public Health, INSERM, CHU University of Montpellier  Montpellier France"},{"name":"Endocrinology\u2010Diabetes\u2010Nutrition Department, CHU Montpellier University of Montpellier  Montpellier France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Duflos","sequence":"additional","affiliation":[{"name":"UMR 1302, Institute Desbrest of Epidemiology and Public Health, INSERM, CHU University of Montpellier  Montpellier France"},{"name":"Clinical Research and Epidemiology Unit, CHU Montpellier University of Montpellier  Montpellier France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9540-8222","authenticated-orcid":false,"given":"Ariane","family":"Sultan","sequence":"additional","affiliation":[{"name":"Endocrinology\u2010Diabetes\u2010Nutrition Department, CHU Montpellier University of Montpellier  Montpellier France"},{"name":"PhyMedExp, INSERM U1046, CNRS UMR 9214 University of Montpellier  Montpellier France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-2052"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1031830"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4522-x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0807"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4488-8"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxh002"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-05056-9"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0148"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12783"},{"key":"e_1_2_12_13_1","first-page":"638","article-title":"Les hospitalisations pour complications podologiques chez les personnes diab\u00e9tiques trait\u00e9es pharmacologiquement, en France en 2013","volume":"34","author":"Fosse\u2010Edorh S","year":"2015","journal-title":"Bull Epid\u00e9miol Hebd"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.respe.2017.05.004"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00038-018-1186-3"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-33"},{"key":"e_1_2_12_17_1","unstructured":"BarletM ColdefyM CollinC GabrielliVL.L\u2019Accessibilit\u00e9 potentielle localis\u00e9e (APL): une nouvelle mesure de l\u2019accessibilit\u00e9 aux soins appliqu\u00e9e aux m\u00e9decins g\u00e9n\u00e9ralistes lib\u00e9raux en France.2012. 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