A team of researchers set out to determine the role timing of prosthesis receipt has in emergency room visits and the association of falls or fall-related injuries with healthcare utilization. This is the second IMPACT study conducted by the clinical and scientific affairs department of Hanger Clinic, Austin, Texas, and researchers from the University of North Carolina at Charlotte’s Department of Public Health. It used data from commercial claims data indicating that receiving a prosthesis within three months after a lower-limb amputation reduced the risk of emergency department utilization, highlighting the value of prostheses during the rehabilitation process.
The study design was a retrospective observational cohort using commercial claims data from the Watson/Truven administrative database 2014-2016. A logistic regression model was used to assess factors that influence emergency department utilization after a lower-limb amputation.
The study sample consisted of 510 adults, ages 18‐64 with continuous enrollment for three years. Independent variables included age, sex, diabetes status, amputation level, fall diagnosis, and prosthesis receipt. A fall was defined as presence of diagnosis code in any outpatient procedure after the amputation date. The main outcome measure was emergency room use after amputation, defined as the presence of procedure codes that billed for emergency department services (99281-99285).
The study revealed that people who receive a prosthesis within zero to three months after a lower-limb amputation were 48 percent less likely to use the emergency department compared to those who did not receive a prosthesis. Individuals who experienced a fall/fall-related injury had 2.8 times the odds of emergency department utilization.
“The IMPACT 2 study not only underscores the significance of long-term health benefits for the patient, including reduced falls and better quality of life, it also highlights the value of cost savings in healthcare utilization that comes with receipt of a prosthesis early on in the rehabilitation process,” said James Campbell, PhD, Hanger’s chief clinical officer. “This is yet another illustration of the holistic benefits of early prosthetic rehabilitation.”
The study, The Role of Earlier Receipt of a Lower Limb Prosthesis on Emergency Department Utilization, was published in PM&R.
