2023 Volume 4 Issue 3 Pages 153-159
As the increase of diabetic foot ulcers（DFU）is considered to be a global challenge, multiple guidelines on DFU strongly recommend the use of off-loading devices. However, it has been shown that the use of such devices is not sufficient across the United States. Although there are several cross-sectional studies on the use of off-loading devices in the U.S., there are still no reports on the use of such devices at a facility level along with insurance coverage information. Therefore, we conducted this study to clarify:（1）the process of providing off-loading devices;（2）types of devices dispensed;（3）insurance coverage for each;（4）frequency of using off-loading devices in an outpatient clinic affiliated with podiatric school in the U.S. The results suggest that in the U.S.:（1）the insurance system is set to promote the use of more evidence-based off-loading devices;（2）convenience, efficiency, and cost of clinic management affect the choice of device;（3）a detailed educational program including insurance coverage information as well as a system considering the convenience and efficiency of clinic management are needed to promote the use of off-loading devices.
