Taxonomy of clinical encounters during the first 90 days post-delivery of an initial lower limb prosthesis

Background: The incidence and etiology of prosthetic services utilization is poorly understood during the first 90 days post-delivery of the initial lower limb prosthesis. This period is of critical importance, as prevailing policy dictates limits on the reimbursement for certain services provided during this time period. The first step in understanding the financial ramifications of such policy is to examine the taxonomy behind clinical encounters during this tenuous time period. Objectives: Quantify and categorize clinical encounters by incidence and etiology. Study design: Retrospective chart review. Methods: A central database containing data on prosthetic services was examined. Incidence and etiology were extracted through independent review of each patient chart. Results: A total of 537 unique patients were identified, with 109 meeting the inclusion criteria. Chi-square testing showed that comfort (p < 0.05), cosmesis (p < 0.01), and mechanical failure (p < 0.001) yielded statistical significance in scheduled versus unscheduled visits. Stepwise regression analysis demonstrated that both sex and K-level were important predictors of unscheduled visits. Conclusion: Taxonomization of clinical encounters experienced during the first 90 days provides a framework for future studies to be conducted. The data provided can serve as a basis for informing reimbursement policy, workforce planning, and advocacy. Clinical relevance: Comfort is the most frequent reason for a clinical encounter during the first 90 days after delivering a lower limb prosthesis. The data on the taxonomy behind the clinical encounters can be used to guide workforce planning and advocate for just reimbursement policy that better reflect patient’s needs.