Multidisciplinary diabetic foot care in Sweden – A national survey

•Diabetic foot ulcers should be managed in a multidisciplinary way for best outcome.•Few clinics report input from specialists in the care of hospitalized foot patients.•The registration of potential quality control markers is poor.•National surveys could reveal geographical inequality in diabetic foot care. To investigate at a national level the multidisciplinary team (MDT) care of patients with diabetes mellitus and foot complications. A questionnaire was sent to all 75 Swedish hospitals with emergency departments, which were grouped according to size. The response rate was 92%, 58/69 of the hospitals have a foot team. Most teams have access to an internal medicine specialist/diabetologist, podiatrist and orthotist. Fewer teams reported access to an orthopaedic surgeon and infectious diseases specialist and only half to a vascular surgeon. In joint MDT outpatient evaluations, the majority report the presence of an internal medicine specialist, podiatrist and orthotist, but 50% an infectious disease specialist and orthopaedic surgeon and only a few a vascular surgeon. In hospitalized patients, there is a reduction in the presence of all specialists. The registration of amputation rate and healed foot ulcers is low. MDT care is mostly adopted among large and medium-sized hospitals in contrast to small ones, which could reflect unequal health care. Vascular surgeons seldom are present at MDT evaluations and there is a reduced regular input of specialists in the evaluation of hospitalized patients. The hospitals’ ability to evaluate their work by potential quality control markers is poor.