amputee, barriers, geriatric, medicare, prosthesis, prosthetics



  1. Highsmith, M. Jason PT, DPT, CP, FAAOP


Barriers impede access to care on many healthcare fronts. Common barriers that restrict access to care include socioeconomic status, race, gender, diagnosis, and age. Four select barriers that impede access to prosthetic care are considered here. They are as follows: (1) Exponential aging: As the baby boomer generation reaches geriatric age, it is difficult to train a sufficient supply of credentialed prosthetists, especially when many of the credentialed prosthetists are also reaching retirement age. (2) Disproportionate geriatric component selection: Only a small number of prosthetic components are specifically identified to be indicated for use with the geriatric client relative to a much larger selection of pediatric and athletic component lines. (3) Reimbursement: Because the functional classification of the amputee dictates the choice and candidacy of components and the process is made subjective through the use of terms such as potential, there is the possibility that many geriatric amputees may be excluded from ever using higher-end components that have advanced safety features. (4) Lack of geriatric representation in prosthetic studies: Many studies of amputees and prosthetics tend to have much smaller sample sizes than their nonprosthetic counterparts. As such, having sufficient geriatric subgroup representation is not likely. The result is generally a poorer body of scientific evidence for the practitioner to draw conclusions from, particularly when concerning the geriatric amputee.