MedStar Authors catalog › Details for: Disparities in wheelchair procurement by payer among people with spinal cord injury.
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Disparities in wheelchair procurement by payer among people with spinal cord injury.

by Groah, Suzanne L; Ljungberg, Inger H; Lichy, Alison.
Citation: Pm & R. 6(5):412-7, 2014 May..Journal: PM & R : the journal of injury, function, and rehabilitation.ISSN: 1934-1482.Full author list: Groah SL; Ljungberg I; Lichy A; Oyster M; Boninger ML.UI/PMID: 24211695.Subject(s): Adolescent | Adult | Aged | Aged, 80 and over | Continental Population Groups/sn [Statistics & Numerical Data] | Cross-Sectional Studies | *Electrical Equipment and Supplies/ec [Economics] | *Electrical Equipment and Supplies/sn [Statistics & Numerical Data] | Female | Financing, Personal/sn [Statistics & Numerical Data] | Humans | Insurance, Health/sn [Statistics & Numerical Data] | Male | Medicaid/sn [Statistics & Numerical Data] | Medicare/sn [Statistics & Numerical Data] | Middle Aged | Paraplegia/ep [Epidemiology] | Quadriplegia/ep [Epidemiology] | *Spinal Cord Injuries/ep [Epidemiology] | United States/ep [Epidemiology] | Veterans Disability Claims/sn [Statistics & Numerical Data] | *Wheelchairs/ec [Economics] | *Wheelchairs/sn [Statistics & Numerical Data] | Workers' Compensation/sn [Statistics & Numerical Data] | Young AdultInstitution(s): MedStar Washington Hospital Center | MedStar National Rehabilitation NetworkDepartment(s): Physical Medicine and RehabilitationActivity type: Journal Article.Medline article type(s): Journal Article | Multicenter StudyDigital Object Identifier: http://dx.doi.org/10.1016/j.pmrj.2013.11.004 (Click here) Abbreviated citation: PM R. 6(5):412-7, 2014 May.Abstract: OBJECTIVE: To identify insurance provider-related disparities in the receipt of lightweight, customizable manual wheelchairs or power wheelchairs with programmable controls among community-dwelling people with spinal cord injury (SCI).Abstract: SETTING: Six Spinal Cord Injury Model System centers.Abstract: DESIGN: A multicenter cross-sectional study.Abstract: PARTICIPANTS: A total of 359 individuals at least 16 years of age or older and 1 year after SCI who use a manual or power wheelchair as their primary means of mobility. The subjects were stratified by payer, and payers were grouped according to reimbursement characteristics as follows: Medicaid/Department of Vocational Rehabilitation (DVR), private/prepaid, Medicare, Worker's Compensation (WC)/Veterans Affairs (VA), and self pay.Abstract: METHODS: Demographic, wheelchair, and payer data were collected by medical record review and face-to-face interview.Abstract: RESULTS: There were 125 participants in the Medicaid/DVR group, 120 in the private/prepaid group, 55 in the Medicare group, 30 in the WC/VA group, and 29 in the self-pay group. For manual wheelchair users, the likelihood of having a lightweight, customizable wheelchair was 97.5% for private/prepaid, 96.3% for Medicaid/DVR, 94.1% for WC/VA, 87.5% for Medicare, and 82.6% for self pay. For power wheelchair users, those with WC/VA (100%) were most likely to receive a customizable power wheelchair with programmable controls, followed by private/prepaid (95.1%), Medicaid/DVR (86.0 %), Medicare (83.9%), and self pay (50.0%).Abstract: CONCLUSIONS: The only payer group for which all beneficiaries received wheelchairs that met standard of care were power wheelchairs provided by WC/VA. Fewer than 90% of people whose manual wheelchair was paid for by Medicare and self pay, and whose power wheelchair was paid for by Medicaid/DVR, Medicare, and self pay did not meet standard of care. Although these findings need to be correlated with long-term risks, such as overuse injuries, breakdowns, and participation, this study demonstrates that disparities in wheelchair procurement by insurance provider persist.Copyright � 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

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