John A Kairalla1, Sandra L Winkler2, Hua Feng3. 1. John A. Kairalla, PhD, is Assistant Professor, Department of Biostatistics, University of Florida, Gainesville. 2. Sandra L. Winkler, PhD, OTR/L, is Research Health Science Specialist, James A. Haley Veterans' Hospital Center of Innovation in Disabilities and Rehabilitation Research, Tampa, FL. 3. Hua Feng, MS, is Senior Biostatistician, Veterans Affairs (VA) Health Services Research & Development Center of Innovation, Michael E. DeBakey VA Medical Center, Houston, TX, and Senior Biostatistician, Department of Medicine, Baylor College of Medicine, Houston, TX.
Abstract
OBJECTIVE: The objective of this study was to determine whether facility-level, structural factors affect the provision of assistive devices and services. DESIGN: A retrospective design was used. Activities of daily living and mobility-related devices were categorized into 11 types. Logistic regression models were performed for each type of device, controlling for patient-level and facility-level covariates. RESULTS: Non-veteran-level factors significantly affect the provision of assistive devices, even after covariate adjustment. Increased rehabilitation clinician staffing by 1 full-time equivalent position was associated with increased provision odds of 1%-5% for 5 of 11 types of devices. Lower facility complexity was significantly associated with increased provision odds of 35%-59% for 3 types of devices and with decreased provision odds of 16%-69% for 3 types of devices. CONCLUSION: System-level factors, in addition to patient need, significantly affect the provision of assistive devices. Provision guidelines could assist clinicians in making decisions about device provision.
OBJECTIVE: The objective of this study was to determine whether facility-level, structural factors affect the provision of assistive devices and services. DESIGN: A retrospective design was used. Activities of daily living and mobility-related devices were categorized into 11 types. Logistic regression models were performed for each type of device, controlling for patient-level and facility-level covariates. RESULTS: Non-veteran-level factors significantly affect the provision of assistive devices, even after covariate adjustment. Increased rehabilitation clinician staffing by 1 full-time equivalent position was associated with increased provision odds of 1%-5% for 5 of 11 types of devices. Lower facility complexity was significantly associated with increased provision odds of 35%-59% for 3 types of devices and with decreased provision odds of 16%-69% for 3 types of devices. CONCLUSION: System-level factors, in addition to patient need, significantly affect the provision of assistive devices. Provision guidelines could assist clinicians in making decisions about device provision.
Authors: Sandra L Hubbard Winkler; Diane C Cowper Ripley; Samuel Wu; Dean M Reker; Bruce Vogel; Shirley G Fitzgerald; William C Mann; Helen Hoenig Journal: Arch Phys Med Rehabil Date: 2010-03 Impact factor: 3.966
Authors: Sandra L Hubbard Winkler; Bruce Vogel; Helen Hoenig; Diane C Cowper Ripley; Samuel Wu; Shirley G Fitzgerald; William C Mann; Dean M Reker Journal: Med Care Date: 2010-06 Impact factor: 2.983
Authors: Dean M Reker; Kimberly Reid; Pamela W Duncan; Clifford Marshall; Diane Cowper; James Stansbury; Kristen L Warr-Wing Journal: J Rehabil Res Dev Date: 2005 Jan-Feb
Authors: C M Ashton; N J Petersen; J Souchek; T J Menke; H J Yu; K Pietz; M L Eigenbrodt; G Barbour; K W Kizer; N P Wray Journal: N Engl J Med Date: 1999-01-07 Impact factor: 91.245