Learning about the changing needs for prosthetics service provision from routinely collected digital centre management data: an exemplar study across three clinics in Cambodia

Abstract

Prosthetic service development and delivery rely on context-specific data describing population needs. However, most existing data come from High-Income Countries or small geographic areas, which are not commonly comparable. In order to provide insights into characteristics of people accessing Cambodian prosthetic services, using digital patient records we investigated trends over three decades in birth year, sex, year and reason for limb absence, and prosthesis type. We extracted cross-sections in 2005 and 2019 indicating how the population accessing prosthetics services has changed.

Temporal trends aligned with Cambodia’s socio-political history. The predominant historical reason for limb absence was weapon trauma during and following conflict, which changed to non-communicable disease and road accidents since 2000. Transtibial remained the most prevalent amputation level but transfemoral amputation had higher incidence for people with limb loss from road accidents, and people with limb loss due to disease were older. Both transfemoral and older-aged groups experience particular rehabilitation challenges.

The study shows how standardised, routinely collected data across multiple clinics within a country can be used to characterise prosthetics service user populations, over time. This indicates the need to track client characteristics and provides evidence for adapting services according to population dynamics and changes in patient need.