HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCE
The emergence of skeletal prosthetic attachments leaves governmental organizations facing the challenge of implementing equitable policies that support the provision of bone-anchored prostheses (BAPs). In 2013, the Queensland Artificial Limb Service (QALS) started a five-year research project focusi...
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Format: | Article |
Language: | English |
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Canadian Online Publication Group (COPG)
2021-09-01
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Series: | Canadian Prosthetics & Orthotics Journal |
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Online Access: | https://jps.library.utoronto.ca/index.php/cpoj/article/view/36210 |
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author | Laurent Frossard Debra Berg |
author_facet | Laurent Frossard Debra Berg |
author_sort | Laurent Frossard |
collection | DOAJ |
description | The emergence of skeletal prosthetic attachments leaves governmental organizations facing the challenge of implementing equitable policies that support the provision of bone-anchored prostheses (BAPs). In 2013, the Queensland Artificial Limb Service (QALS) started a five-year research project focusing on health service delivery and economic evaluation of BAPs. This paper reflects on the QALS experience, particularly the lessons learned. QALS’ jurisdiction and drivers are presented first, followed by the impact of outcomes, barriers, and facilitators, as well as future developments of this work. The 21 publications produced during this project (e.g., reimbursement policy, role of prosthetists, continuous improvement procedure, quality of life, preliminary cost-utilities) were summarized. Literature on past, current, and upcoming developments of BAP was reviewed to discuss the practical implications of this work. A primary outcome of this project was a policy developed by QALS supporting up to 22 h of labor for the provision of BAP care. The indicative incremental cost-utility ratio for transfemoral and transtibial BAPs was approximately AUD$17,000 and AUD$12,000, respectively, per quality-adjusted life-year compared to socket prostheses. This project was challenged by 17 barriers (e.g., limited resources, inconsistency of care pathways, design of preliminary cost-utility analyses) but eased by 18 facilitators (e.g., action research plan, customized database, use of free repositories). In conclusion, we concluded that lower limb BAP might be an acceptable alternative to socket prostheses from an Australian government prosthetic care perspective. Hopefully, this work will inform promoters of prosthetic innovations committed to making bionic solutions widely accessible to a growing population of individuals suffering from limb loss worldwide.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36210/28330
How To Cite: Berg D, Frossard L. Health service delivery and economic evaluation of limb lower bone-anchored prostheses: A summary of the Queensland artificial limb service’s experience. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.12. https://doi.org/10.33137/cpoj.v4i2.36210
Corresponding Author: Laurent Frossard, PhD, Professor of Bionics
YourResearchProject Pty Ltd, Brisbane, Australia.
E-Mail: laurentfrossard@outlook.com
ORCID number: https://orcid.org/0000-0002-0248-9589 |
first_indexed | 2024-04-11T19:31:46Z |
format | Article |
id | doaj.art-508480c25eaa4a8a931013b67c1f9787 |
institution | Directory Open Access Journal |
issn | 2561-987X |
language | English |
last_indexed | 2024-04-11T19:31:46Z |
publishDate | 2021-09-01 |
publisher | Canadian Online Publication Group (COPG) |
record_format | Article |
series | Canadian Prosthetics & Orthotics Journal |
spelling | doaj.art-508480c25eaa4a8a931013b67c1f97872022-12-22T04:06:58ZengCanadian Online Publication Group (COPG)Canadian Prosthetics & Orthotics Journal2561-987X2021-09-014210.33137/cpoj.v4i2.36210HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCELaurent Frossard0Debra Berg11)YourResearchProject Pty Ltd, Brisbane, Australia. 2) Griffith University, Gold Coast, Australia. 3) University of the Sunshine Coast, Maroochydore, Australia. 4) Queensland University of Technology, Brisbane, AustraliaQueensland Artificial Limb Service, Brisbane, Australia. The emergence of skeletal prosthetic attachments leaves governmental organizations facing the challenge of implementing equitable policies that support the provision of bone-anchored prostheses (BAPs). In 2013, the Queensland Artificial Limb Service (QALS) started a five-year research project focusing on health service delivery and economic evaluation of BAPs. This paper reflects on the QALS experience, particularly the lessons learned. QALS’ jurisdiction and drivers are presented first, followed by the impact of outcomes, barriers, and facilitators, as well as future developments of this work. The 21 publications produced during this project (e.g., reimbursement policy, role of prosthetists, continuous improvement procedure, quality of life, preliminary cost-utilities) were summarized. Literature on past, current, and upcoming developments of BAP was reviewed to discuss the practical implications of this work. A primary outcome of this project was a policy developed by QALS supporting up to 22 h of labor for the provision of BAP care. The indicative incremental cost-utility ratio for transfemoral and transtibial BAPs was approximately AUD$17,000 and AUD$12,000, respectively, per quality-adjusted life-year compared to socket prostheses. This project was challenged by 17 barriers (e.g., limited resources, inconsistency of care pathways, design of preliminary cost-utility analyses) but eased by 18 facilitators (e.g., action research plan, customized database, use of free repositories). In conclusion, we concluded that lower limb BAP might be an acceptable alternative to socket prostheses from an Australian government prosthetic care perspective. Hopefully, this work will inform promoters of prosthetic innovations committed to making bionic solutions widely accessible to a growing population of individuals suffering from limb loss worldwide. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36210/28330 How To Cite: Berg D, Frossard L. Health service delivery and economic evaluation of limb lower bone-anchored prostheses: A summary of the Queensland artificial limb service’s experience. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.12. https://doi.org/10.33137/cpoj.v4i2.36210 Corresponding Author: Laurent Frossard, PhD, Professor of Bionics YourResearchProject Pty Ltd, Brisbane, Australia. E-Mail: laurentfrossard@outlook.com ORCID number: https://orcid.org/0000-0002-0248-9589https://jps.library.utoronto.ca/index.php/cpoj/article/view/36210Artificial LimbsBionicsBone-Anchored ProsthesisCost-EffectivenessCost-UtilityHealth Economic Evaluation |
spellingShingle | Laurent Frossard Debra Berg HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCE Canadian Prosthetics & Orthotics Journal Artificial Limbs Bionics Bone-Anchored Prosthesis Cost-Effectiveness Cost-Utility Health Economic Evaluation |
title | HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCE |
title_full | HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCE |
title_fullStr | HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCE |
title_full_unstemmed | HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCE |
title_short | HEALTH SERVICE DELIVERY AND ECONOMIC EVALUATION OF LIMB LOWER BONE-ANCHORED PROSTHESES: A SUMMARY OF THE QUEENSLAND ARTIFICIAL LIMB SERVICE’S EXPERIENCE |
title_sort | health service delivery and economic evaluation of limb lower bone anchored prostheses a summary of the queensland artificial limb service s experience |
topic | Artificial Limbs Bionics Bone-Anchored Prosthesis Cost-Effectiveness Cost-Utility Health Economic Evaluation |
url | https://jps.library.utoronto.ca/index.php/cpoj/article/view/36210 |
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