The effectiveness and cost-effectiveness of upper limb prostheses

The cost of upper limb prostheses related health care are rising. One reason may be the more frequent prescription of the expensive multi-grip myoelectric hand prostheses. However, signs of non-usage of the additional grip options of these hands are described. In these cases, a more simple prosthesis might also suit the users’ needs. Therefore, we investigated: 1. Factors that affect prosthesis choice and use A qualitative meta-synthesis, focus group and a nationwide survey in which 358 participants selected their top-10 most important items regarding prosthesis use were performed. Based on these results, a measurement tool, the PUF-ULP, was developed, which provides a single score that represents the match between the user and their prosthesis. 2. Cost-effectiveness of upper limb prosthesis A total of 242 upper limb prostheses users completed a quality of life questionnaire, the PUF-ULP, and a cost questionnaire. Results indicated that myoelectric prostheses, especially the multi-grip ones, are the most expensive compared to other prostheses types, while no differences in quality of life or user experiences were apparent. 3. Multi-grip versus standard myoelectric hands Fourteen multi-grip myoelectric hand prosthesis users performed multiple tests with both the multi-grip and standard myoelectric hand. Additionally, the users’ experiences of the multi-grip myoelectric hand prostheses were compared with these of 19 standard myoelectric hand prosthesis users using questionnaires. Results showed no relevant advantages of the multi-grip hand over the standard hand. 4. Development decision aidIn a systematic co-creation process a decision aid about hand prosthesis was developed and implemented nationwide