Governmental perspective on fair and equitable provision of bone-anchored prostheses: Barriers and facilitators

Background Individuals with lower limb amputation fitted with conventional artificial limbs often experience continuous socket-related discomfort leading to a dramatic decrease in quality of life. Most of these functional issues can be overcome by replacing the socket with a surgically implanted bone-anchored prosthesis attached directly to the residual bone using an osseointegrated fixation.[1-31] Government organizations are facing challenges in adjusting procedures to accommodate the emergence of bone-anchored prostheses.[32-35] This study shares the knowledge gained by the Queensland Artificial Limb Service (QALS) an Australian State government organization, while implementing a procedure for fair and equitable provision of bone-anchored prostheses care. Aim The aim of this study was to share some insights drawn from QALS’ experience with strong emphasis on barriers and facilitators encountered when implementing procedure for provision of bone-anchored prostheses care in Queensland, Australia. Method Barriers and facilitators were identified over nearly 3 years following typical phases of action research led by QALS’ management team and researchers who consulted key stakeholders (e.g., 18 Queensland - based consumers, 3 prosthetists, 2 multidisciplinary clinical teams).