Article

OBJECTIVE: To characterize the opinion of the prosthetic clinical care community
on the Medicare Functional Classification Level (K-level) assignment process to
classify the mobility and rehabilitation potential of persons with lower-limb
loss, including limitations and practicalities involved with the integration of
outcome measures (OMs) into the clinical practice framework for K-level
assignment. DESIGN: Survey. SETTING: English online questionnaire with built-in
logic. PARTICIPANTS: Volunteer sample of prosthetics practitioners (N=236). Data
were analyzed only for U.S. practitioners (n=213). INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Subjective responses to 19 multiple choice, Likert scale,
and open-ended questions. RESULTS: Forty-seven percent of respondents indicated
that they were the sole determinant in the K-level assignment process, while 43%
indicated that it was a collaborative process with other health care
professionals. Sixty-nine percent of respondents reported using standardized OMs
to assist in K-level assignment, and most did not agree that commonly reported
barriers to implementation (eg, lack of time and training) were relevant.
Sixty-seven percent of respondents did not believe the K-level system can
accurately assign a level of rehabilitation potential, with 75% agreeing that
incorporating OMs into clinical practice would enhance objectivity of the K-level
assignment process. CONCLUSIONS: The results suggest that most prosthetics
practitioners are involved in the K-level assignment at some level, and most
agreed that there are considerable limitations with this system. To address these
issues, many practitioners are using OMs to assess various aspects of patient
mobility and rehabilitation potential, and minimize the subjectivity of the
assignment process.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS