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首页> 外文期刊>Journal of prosthetics and orthotics: JPO >Projected Health Care Associated Costs of Workplace-Related Traumatic Amputation After 10,15, and 20 Years: Part I: Lower Limb
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Projected Health Care Associated Costs of Workplace-Related Traumatic Amputation After 10,15, and 20 Years: Part I: Lower Limb

机译：预计医疗保健相关的工作场所相关的创伤截肢成本10,15和20年：第一部分：下肢

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Introduction: Previous research has determined the impact of different types of lower-limb prostheses on functional and biome-chanical outcomes. Little work, however, has examined the effect of amputation and prostheses on health care costs. The purpose of this investigation was to estimate long-term health care associated costs in individuals with lower-limb amputation of varying limb loss level. Materials and Methods: An insurance claims database was obtained via a public records request from the Ohio Bureau of Workers' Compensation for 361 persons who experienced a traumatic injury in the workplace that resulted in lower-limb amputation. Insurance claims included costs associated with prosthetic limbs and equipment, general hospital care, physical therapy, vocational therapy, prescription medication, and additional health care categories. The population was categorized into two limb loss levels: persons with unilateral transtibial amputation and persons with transfemoral amputation. Prosthetic insurance claim codes were examined to determine and classify the type of prostheses prescribed, based on Medicare guidelines for activity levels (K1-K4), to estimate yearly health care costs associated with each type of prosthesis. These data were used to construct Markov decision models to estimate the expected distribution of long-term (10,15, and 20 years) health care costs after receiving a prosthesis associated with transtibial and transfemoral amputation. Results: Sixty-two persons with transfemoral amputation and 108 persons with transtibial amputation met our inclusion/ exclusion criteria. Average time between prosthesis prescriptions varied based on activity and limb loss levels, and on average, individuals with transtibial amputation received a new prosthesis every 1.3 ± 1.6 years and individuals with transfemoral amputation every 2.3 ± 1.8 years. Annual costs associated with activity and limb loss levels varied greatly over time, ranging from $3,000 to $150,000 per patient. Projected health care associated costs totaled $546,067 ± $293,411 and $253,766 ± $142,206 over 20 years for transfemoral and transtibial amputations, respectively. Conclusions: The results of this cost investigation provide new information regarding all aspects of health care for individuals with lower-limb amputation, including trends in prosthesis prescription and yearly costs, and how prosthetic prescription may alter these long-term costs.
机译：简介：以前的研究已经确定了不同类型的低肢假体对功能性和生物血液组合的影响。然而，一点工作已经检查了截肢和假体对医疗费用的影响。本调查的目的是估计具有不同肢体损失水平的低肢截肢的个体的长期保健相关成本。材料和方法：保险索赔数据库是通过从俄亥俄州工人局赔偿的公共记录要求获得的361人在工作场所造成创伤患者的赔偿局的赔偿。保险索赔包括与假肢和设备相关的成本，普通医院护理，物理治疗，职业治疗，处方药和额外的医疗保健类别。人口被分为两个肢体损失水平：单方面打击截肢的人和截肢截肢的人。审查了假肢保险索赔代码，以确定和分类规定的假体类型，根据医疗保险准则（K1-K4），估计与每种类型的假肢相关的年度医疗保健费用。这些数据用于构建马尔可夫决策模型，以估计在接受与抗殖民截肢相关的假体后长期（10,15和20年）的医疗保健成本的预期分布。结果：六十二人截肢截肢和108人，具有剧本截肢的108人达到了纳入/排除标准。假体处方之间的平均时间基于活动和肢体损失水平而变化，平均而言，具有串易截肢的个体每1.3±1.6岁，每个2.3±1.8岁的截肢每1.3±1.6岁和个体接受新的假体。与活动和肢体损失水平相关的年度成本随着时间的推移而变化大大变化，从每位患者的3,000美元到150,000美元。预计的医疗保健相关费用分别为293,411美元，分别为293,411美元和253,766澳元超过20年，超过20年，以超过20年的违法行为和打击截肢。结论：这项成本调查的结果提供了有关具有较低肢体截肢的人的医疗保健的所有方面的新信息，包括假肢处方和年费的趋势，以及假期的处方如何改变这些长期成本。

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