{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:17:56Z","timestamp":1782098276076,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early mobility, functional independence, and ambulation are associated benefits after lower limb amputation (LLA), whereas an increased risk of clinical complications is associated with no prosthesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe time to prosthesis receipt after amputation and to assess the impact of patient demographic and health factors on the rate of prosthesis receipt within 12\u2009months post LLA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cohort analysis using commercial administrative claims data. Kaplan\u2010Meier and Cox proportional\u2010hazards models were applied to assess time to prosthesis receipt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Watson\/Truven administrative database 2014\u20102016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adults aged 18\u201064 years with LLA who maintained their current insurance enrollment for 12\u2009months after amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Independent variables included diabetes\/vascular disease status, amputation level, age, gender, and region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Prosthesis receipt was defined based on the presence of codes billed for prosthesis services. Time was measured in days from date of amputation surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the sample, 510 individuals maintained insurance enrollment for 12\u2009months after amputation, of which 443 individuals received a prosthesis within that period (79% below knee and 21% above knee). The adjusted average rate of time to prosthesis receipt was 138 (95% confidence interval [CI]: 113\u2013185) days. Individuals with diabetes\/vascular disease were 22% (hazard ratio: 1.22, 95% CI: 1.02\u20131.49) more likely to receive a prosthesis earlier than individuals without diabetes\/vascular disease and women received a prosthesis later than men at 141 (95% CI: 126\u2013162) days versus 106 (95% CI: 96\u2013119) days, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study expands the understanding of factors that influence the likelihood of receiving a prosthesis along with the timing of prosthesis receipt after LLA among commercially insured adults. At least half of this sample received a prosthesis within 5\u00a0months or less. Disparities in timing and access to a prosthesis based on amputation level and gender were noted; future efforts are needed to address these issues.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12781","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T12:22:48Z","timestamp":1643977368000},"page":"474-481","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Factors that influence time to prosthesis receipt after lower limb amputation: A Cox proportional hazard model regression"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7117-6124","authenticated-orcid":false,"given":"Taavy A.","family":"Miller","sequence":"first","affiliation":[{"name":"School of Public Health University of North Carolina at Charlotte  Charlotte North Carolina USA"},{"name":"Hanger Institute for Clinical Research and Education  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajib","family":"Paul","sequence":"additional","affiliation":[{"name":"School of Public Health University of North Carolina at Charlotte  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Forthofer","sequence":"additional","affiliation":[{"name":"School of Public Health University of North Carolina at Charlotte  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane R.","family":"Wurdeman","sequence":"additional","affiliation":[{"name":"Hanger Institute for Clinical Research and Education  Austin Texas USA"},{"name":"Department of Biomechanics University of Nebraska at Omaha  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977\u20101962"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977\u20101846"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0309364617690394"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2014.09.0216"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED\u2010D\u201015\u201000545"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0309364615596067"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2014.09.0209"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2007.01187.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.21300\/18.2\u20103.2016.85"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0309364617736089"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2014.09.003"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2015.11.012"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2014.05.024"},{"key":"e_1_2_8_15_1","unstructured":"TherneauTM.A Package for Survival Analysis in R. 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