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BACKGROUND/RATIONALE:
A recent Department of Defense (DoD) Rehabilitation Directive aims to return amputees from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) to pre-injury function and provide the option of returning to active duty. To meet this goal, Walter Reed and Brooke Army Medical Center Rehabilitation Centers offer state-of-the-art rehabilitation care and prosthetic devices. Current state-of-the-art prosthetic technology is approximately six times more expensive than prosthetic technology used in 2000. VA limb distribution practice now allows all veteran amputees to request and receive any prosthetic device.
OBJECTIVE(S):
To provide VA clinicians and policy-makers information on changes in prosthetic utilization patterns, project costs, amputee satisfaction prosthetic procurement alternatives and expert recommendations to guide future prosthesis-related personnel, laboratory and economic decisions.
METHODS:
Research Plan: Survey of all OEF/OIF amputees one-year-post-initial amputation and 500 Vietnam War amputees to determine amputee prosthetic utilization and costs. Data will be used to generate economic models to forecast the 5-year, 10-year, 20-year and lifetime cost of the prostheses for amputees.
Principal Sources of Data: Amputee Database, Austin databases, Compensation and Pension databases. Data on prosthetic satisfaction will be collected with surveys of amputees from Operation Enduring Freedom and Operation Iraqi Freedom and from a sample of Vietnam War amputees. Data for trends of prosthetic utilization will be evaluated by a panel of experts on rehabilitation and prosthetic devices.
Principal Type of Analysis: Markov models with a finite number of states for the economic assessments comparing projected prosthetic use by the three methods of procurement (prosthetics engineered by VA prosthetists, reimbursed by Medicare or purchased from commercial sources).
Population: Major amputees from Operation Enduring Freedom and Operation Iraqi Freedom and a sub-sample of veteran amputees from the Vietnam War. No restrictions on age, gender or ethnic group.
FINDINGS/RESULTS:
Survey enrollment concluded 8/1/08. Survey response rate is 70%.
IMPACT:
Amputations and subsequent prosthetic use are high priorities for the VA system. Future prosthetic utilization is influenced by the new DoD directive and new technology. This research will provide information to assist VA clinicians, administrators and policy makers in their paradigm shift in VA Amputee care.
PUBLICATIONS:
None at this time.
DRA:
Acute and Traumatic Injury, Military and Environmental Exposures, Special (Underserved, High Risk) Populations
DRE:
Resource Use and Cost, Rehabilitation, Technology Development and Assessment
Keywords:
Utilization patterns
MeSH Terms:
none
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