title: Foot health service provision by the Australian Department of Veterans' Affairs: do major podiatric medical interventions reduce the number of maintenance treatments?
abstract: BACKGROUND
  In Australia, the Department of Veterans' Affairs provides podiatric medical services, including nail surgery and the provision of footwear and orthoses, for war veterans and their dependents. We sought to evaluate whether the provision of these interventions reduces the number of ongoing maintenance treatments.
  
  
  METHODS
  We used the database of the Department of Veterans' Affairs to document the number of major podiatric medical interventions (footwear, foot orthoses, nail surgery, and combinations of these interventions) for 1996-1997. The number of maintenance podiatric medical treatments provided in the 2 years before (1994-1996) and 2 years after (1997-1999) these interventions was then compared with a control group that did not receive any major interventions.
  
  
  RESULTS
  Compared with the number of treatments in the 2 years before the interventions, in the subsequent 2 years there was a significant increase in the mean +/- SD number of maintenance treatments after receiving footwear only (10.4 +/- 5.8 versus 12.3 +/- 5.0), foot orthoses only (9.4 +/- 5.3 versus 12.2 +/- 4.6), nail surgery only (10.2 +/- 5.8 versus 13.2 +/- 4.4), and footwear plus foot orthoses (9.3 +/- 6.1 versus 13.3 +/- 5.5). In the control group, the mean number of treatments in 1994-1996 and 1997-1999 was 10.8 and 11.8, respectively.
  
  
  CONCLUSIONS
  Provision of major podiatric medical interventions did not reduce the number of ongoing maintenance treatments received by veterans. However, owing to the inherent limitations of claims data, it is difficult to determine whether this finding is due to the limited efficacy of the interventions or to the policy structure of podiatric medical service provision in the Department of Veterans' Affairs.
authors.affiliation: Department of Podiatry, Division of Allied Health, La Trobe University, Bundoora, Victoria 3086, Australia.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Frescos
authors.forename: Hylton B
authors.initials: HB
authors.lastname: Menz
mesh_terms: D000368:Aged; D001315:Australia; D005260:Female; D005534:Foot Diseases / Q000628:therapy*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009989:Orthotic Devices / Q000706:statistics & numerical data; D011032:Podiatry / Q000458:organization & administration*; D015397:Program Evaluation; D014728:Veterans