The Economic Value of Mobility with a Prosthesis

Abstract

The primary purpose for creation of a leg prosthesis is to enable mobility, including standing, transferring, and walking. It is proposed that to adequately assess the health economic ramifications of alternatives in prosthetic care for persons who have had an amputation, one should consider the value of mobility. This article explores some key constructs in elucidation of the value of mobility with a prosthesis: 1) mobility is not binary; it has quality aspects that impact its value; 2) overall direct health care costs have been shown to be reduced beyond the cost of associated prosthetic technologies when this technology improves safety and reduces injury; 3) amputation creates chronic disability that is better reflected by the burden of disease than by mortality alone in health economic analyses; and 4) significant indirect value is provided by a prosthesis that enables physical activity and the resulting health benefits. Human needs and health economic goals can be aligned. Invention of new technology that maximizes physical restoration and human potential should be evaluated not only on its cost, but also on the substantial value provided.