Linda Resnik is a Research Career Scientist at the US Department of Veterans Affairs (VA) Providence VA Medical Center (VAMC), and Professor of Health Services, Policy and Practice at Brown University in Rhode island, Matthew Borgia is a Biostatistician; and Sarah Ekerholm is a Program Manager in the Research Department, Providence VAMC. Melissa Clark is an Adjunct Professor at University of Massachusetts Medical school in Worcester and Professor of Health Services Policy and Practice, Brown University. Jason Highsmith is a National Program Director at the VA Rehabilitation and Prosthetics Services, Orthotic & Prosthetic Clinical Services in Washington, DC and is Professor at the University of South Florida, Morsani College of Medicine, School of Physical Therapy & Rehabilitation Sciences in Tampa. Billie Randolph is Deputy Director of the Extremity Trauma and Amputation Center of Excellence. Joseph Webster is a Professor in the Department of Physical Medicine and Rehabilitation, School of Medicine at Virginia Commonwealth University and aStaff Physician, Physical Medicine and Rehabilitation Hunter Holmes McGuire VAMC in Richmond. Correspondence: Linda Resnik (linda.resnik@va.gov)
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article. This work was funded by the Office of the Assistant Secretary of Defense for Health Affairs, through the Orthotics and Prosthetics Outcomes Research Program Prosthetics Outcomes Research Award (W81XWH-16- 675 2-0065) and the U.S Department of Veterans Affairs (VA RR&D, A2707-I and VA RR&D A9264A-S).
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the US Government, or any of its agencies.
Despite these limitations, we believe that our study provides novel, important findings about the satisfaction with prosthetic limb care services and quality of amputation rehabilitation care for veterans. Findings from this study can be used to address amputation and prosthetic limb care satisfaction and quality weaknesses highlighted and to benchmark care satisfaction and CPG compliance. Other studies evaluating care guideline compliance have used indicators obtained from clinical records or data repositories.13-15 Future work could combine self-reported satisfaction and care quality measures with indicators obtained from clinical or repository sources to provide a more complete snapshot of care delivery.
Conclusions
We reported on a national survey of veterans with major upper limb loss that assessed satisfaction with prosthetic limb care services and quality of amputation care. Satisfaction with prosthetic limb care was independently associated with satisfaction with the prosthesis, and receipt of care within the prior year. Most of the veterans surveyed received care within the VA or DoD and reported receiving higher quality of care, when compared with those who received care outside of the VA or DoD. Satisfaction with care and quality of care were stable over the year of this study. Data presented in this study can serve to direct VA amputation care process improvement initiatives as benchmarks for future work. Future studies are needed to track satisfaction with and quality of care for veterans with ULA.
