Health Care Economics in Lower-Limb Amputation Surgery, Prosthetics, and Rehabilitation: A Narrative Systematic Review of the Literature

摘要

Health expenditures in the United States are substantial, accounting for 17.8% of gross domestic product (GDP) in 2015. These expenditures are expected to increase to nearly 20% of GDP by 2025. National health spending in the US is projected to grow at an average rate of 5.6% per year between 2016 and 2025 and a 4.7% rate annually on a per capita basis.1 The economic impact of lower-limb amputation (LLA) is variable, with estimated lifetime prosthetic costs for those who use them ranging from $0.5 to $1.8 million, depending upon the number and type of prostheses received, the number and type of limb amputations, and other factors.2 Collectively, Medicare reimbursed $655 million worth of lower-limb prosthetic services in 2009.3 However, prosthetic costs only constitute a portion of the full economic impact, with reported cumulative societal costs (United States) of an estimated $4.3 billion for persons with amputations of dysvascular etiology.