A research paper that was published May 22 in the online issue of Disability and Rehabilitation: Assistive Technology quantifies prescription and repair rates of prosthetic limbs in the U.S. Department of Veterans Affairs (VA) and explores differences by level, type, and age. The authors say their results have implications for national insurance fairness for amputees laws.
The researchers examined the records of 32,440 veterans who had an initial prosthetic prescription between 2000 and 2010, and classified them by amputation level and type. Annual rates of prescription and repair were calculated using person-time and compared by group. They found that veterans with upper-limb amputation had lower annual prescription and repair rates compared with those with lower-limb amputation. Myoelectric devices users had higher prescription rates; however, body-powered prosthetic users had higher repair rates. Prescription and repair rates for microprocessor knee joints were higher than for fluid and friction devices. Veterans under 65 years of age had higher rates of prescription and repair than those older than 65.
Because the VA is unconstrained by co-pays or caps, the authors said that the data on VA prosthetic prescription and repair can be used to estimate rates that might occur if national insurance fairness for amputees laws were adopted. Given the rates found, they said it is likely that annual costs would exceed the typical annual and/or lifetime caps in most insurance plans. In states without insurance fairness for amputees laws, such costs likely limit access to needed devices.
