Improving access to prosthetic limbs in Germany: An explorative review

Area of Science:

• Prosthetics and Rehabilitation Engineering
• Health Services Research
• Bioethics

Background:

• Access to prosthetic limbs is crucial for user acceptance and function.
• Financial challenges and meeting user needs are key factors in prosthesis utilization.
• Understanding barriers to prosthetic limb access is vital for improving patient outcomes.

Purpose of the Study:

• Investigate hurdles in accessing prosthetic limbs within the German healthcare system.
• Examine organizational, social, economic, and regulatory issues affecting prosthetic care.
• Explore ethical implications of prosthetic access and reimbursement.

Main Methods:

• Conducted semistructured interviews with 16 German limb prosthetic users.
• Interviewed 10 stakeholders including insurance representatives and prosthetic technicians.
• Analyzed qualitative data using a content analysis method.

Main Results:

• Half of users reported difficulties accessing suitable prostheses, including long waiting times.
• Users experienced pressure to justify their need for specific prosthetic devices.
• Stakeholder views on prosthetic reimbursement issues showed both commonalities and conflicts.

Conclusions:

• Organizational and regulatory improvements can enhance equitable access to prostheses.
• User-centered design and health technology assessment are recommended.
• Monitoring care pathways and societal discussion on rationing are crucial for comprehensive solutions.