Health Services Research & Development

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2005 HSR&D National Meeting Abstract


3077 — Characterization of Veterans Prescribed Wheelchairs and Scooters by the VHA

Author List:
Hubbard SL (RORC, Gainesville VA)
Fitzgerald SG (HERL, Pittsburgh VA)
Reker DM (RORC, Gainesville VA)
Boninger ML (HERL, Pittsburgh VA)
Cooper RA (HERL, Pittsburgh VA)
Kazis LE (HERL, Pittsburgh VA)

Objectives:
To characterize veterans who received wheeled mobility devices (WMDs), wheelchairs and scooters, from the VHA and investigate whether the type of wheelchair provided was associated with age, gender, or race/ethnicity.

Methods:
Using a retrospective study design, data from the National Prosthetic Patient and National Patient Care Databases were merged to create a dataset (N=243,158 records) of veterans who received WMDs from the VHA during FY99-01. WMDs were stratified by type: standard, lightweight, and ultralight manual wheelchairs, standard and custom power wheelchairs, and scooters. Descriptive statistics and logistic regression were performed for each wheelchair type.

Results:
During FY99-01, more than 191,000 WMDs were provided to veterans by the VHA. The wheelchair most frequently prescribed across diagnoses was the standard manual wheelchair. Veterans with Chronic Obstructive Pulmonary Disease/ Chronic Heart Failure accounted for 22-23% of WMDs prescribed, followed by stroke patients, with 15-17%. Over the 3-year period, 79% of WMDs provided were manual wheelchairs, 8% were power wheelchairs, and 13% were scooters. Of the WMD prescribed for Caucasians, 77% were manual wheelchairs, 9% were power wheelchairs, and 14% were scooters. Of the WMD prescribed for Hispanics, 90% were manual wheelchairs, 5% were power wheelchairs, and 5% were scooters. Of the WMD prescribed for African Americans, 82% were manual wheelchairs, 8% were power wheelchairs, and 10% were scooters. Of the WMD prescribed for American Indians/Asians, 84% were manual wheelchairs, 8% were power wheelchairs, and 8% were scooters. After controlling for diagnosis and number of comorbidities, Hispanics (OR=1.8), American Indian/ Asians (OR=1.6), and African Americans (OR=1.4) were more likely to receive manual wheelchairs. Hispanics (OR=0.4), American Indian/Asians (OR=0.4), and African Americans (OR=0.7) were less likely to receive scooters. In addition, Hispanics (OR=0.8) and African Americans (OR=0.9) were less likely to receive power wheelchairs.

Implications:
Variation in the provision of wheelchairs suggests potential ethnic disparity in the provision of WMD in a national sample. Future studies are warranted to examine potential disparities and implications for patient care.

Impacts:
Results of this study will be used to guide future analyses, which may lead to more equitable and standardized prescription of WMD throughout the VHA.