Healthcare Inspection - Prosthetic Limb Care in VA Facilities

At the request of the Chairman of the House Committee on Veterans’ Affairs, the OIG conducted a review to evaluate VA’s capacity to deliver prosthetic care. By analysis of integrated data from VA and DoD for nearly 500,000 veterans, we found veterans with traumatic amputations are a complex population with a variety of medical conditions and are significant users of all VA healthcare services, not just prosthetic services. Furthermore, this is the first ever study to characterize the population of 1,288 OEF/OIF/OND servicemembers with major traumatic amputations. We found that OEF/OIF/OND veterans generally were adapting to living with their amputations. However, veterans with upper extremity amputations consistently did not fare as well as those veterans with lower extremity amputations in their psychosocial adaptation, activity limitation, and prosthetic satisfaction. We recommended that VHA consider (1) the wide-ranging medical needs of traumatic amputees beyond the prosthetic and mental health concerns identified in this report; then adjust, if necessary, the provision and management of health care services accordingly; (2) evaluating the needs of veterans with traumatic upper limb amputations to improve their satisfaction; and (3) veterans’ concerns with VA approval processes for fee-basis and VA contract care for prosthetic services to meet the needs of veterans with amputations. VHA concurred with our recommendations and provided acceptable action plans.