Abstract
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.
Keywords
List of abbreviations:
AMP (Amputee Mobility Predictor), MFCL (Medicare Functional Classification Level), OM (outcome measure)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 22, 2016
Footnotes
This work was supported in part by a Career Development Award (Award #1IK2RX001322-01A1) from the United States (U.S.) Department of Veterans Affairs Rehabilitation Research and Development Service. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
