Affiliations: [a] Rehabilitation Foundation Limburg, Hoensbroek, The Netherlands | [b] Maastricht University, Research School CAPHRI, Department of Health Organization, Policy and Economics, Maastricht, The Netherlands | [c] Maastricht University, Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht, The Netherlands
Correspondence:
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Address for correspondence: H.A.M. Seelen, PhD, Rehabilitation Foundation Limburg (SRL), Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands. Tel.: +31 45 528 22 21; Fax: +31 45 528 22 27; E-mail: h.seelen@srl.nl.
Abstract: Electronically controlled prosthetic knee joints have been introduced to meet ambulation demands of leg amputees. This study assessed whether microprocessor-controlled knee joints or non-electronically controlled knee joints are to be preferred regarding costs and functional health. Thirteen participants with a unilateral knee/hip disarticulation or transfemoral amputation wore a prosthesis featuring a microprocessor-driven knee joint (C-group). Thirteen similar upper-leg amputees used a non-electronic knee joint (N-group). Direct and indirect costs were established using a cost questionnaire, the PRODISQ, and database records of the Hoensbroeck Rehabilitation Centre. Intervention costs, health care costs, patients/family costs, productivity costs and total costs were calculated. Functional health was measured using the SF-36 (SF-6D). Total costs averaged from € 39,350 (C-group) to € 46,086 (N-group). In the C-group intervention costs were 28.2% higher (p = 0.043) as were prosthetics costs (p = 0.000). Patients/family costs amounted to € 7,094 (C-group) and € 12,992 (N-group) (p = 0.053). In the N-group housekeeping assistance cost € 4,058 more (p = 0.007), and productivity loss was higher (p = 0.051). SF-6D scores and SF-36 sub-scores were higher in the C-group (p-values between 0.001 and 0.071). Higher purchasing costs for prostheses with a microprocessor-controlled knee joint seem to be counterbalanced by lower costs in other domains. Functional health was clearly higher in the C-group.
Keywords: Cost effectiveness analysis, leg prosthesis, rehabilitation
