Volume 44 Number 4 2007
Pages 581 — 592

Abstract - Distribution and cost of wheelchairs and scooters provided by Veterans Health Administration

Sandra L. Hubbard, PhD, OTR/L, ATP;1-2* Shirley G . Fitzgerald, PhD;3-4 Bruce Vogel, PhD;2,5 Dean M. Reker, PhD, RN;6-7 Rory A. Cooper, PhD;3-4 Michael L. Boninger, MD4,8

1Occupational Therapy Department, College of Public Health and Health Professions, University of Florida, Gainesville, FL; 2Rehabilitation Outcomes Research Center of Excellence, North Florida/South Georgia Veterans Health System, Gainesville, FL; 3Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA; 4Human Engineering Research Laboratories, Department of Veterans Affairs (VA) Pittsburgh Healthcare System, Pittsburgh, PA; 5Epidemiology and Health Policy Research Department, College of Medicine, University of Florida, Gainesville, FL; 6VA Medical Center, Kansas City, MO; 7University of Kansas Medical Center, Kansas City, KS; 8Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA

Abstract — During fiscal years 2000 and 2001, the Veterans Health Administration provided veterans with more than 131,000 wheelchairs and scooters at a cost of $109 million. This national study is the first to investigate Veterans Health Administration costs in providing wheelchairs and scooters and to compare regional prescription patterns. With a retrospective design, we used descriptive methods to analyze fiscal years 2000 and 2001 National Prosthetics Patient Database data (cleaned data set of 113,724 records). Wheelchairs were categorized by function, weight, and adjustability options for meeting individual needs (e.g., axle position, camber, position of wheels, tilt, and recline options). Results displayed a cost distribution that was negatively skewed by low-cost accessories coded as wheelchairs. Of the standard manual wheelchairs, 3.5% could be considered beyond the customary cost. Regionally, 71% to 86% of all wheelchairs provided were manual wheelchairs, 5% to 11% were power wheelchairs, and 5% to 20% were scooters. The considerable variation found in the types of wheelchairs and scooters provided across Veterans Integrated Service Networks may indicate a need for evidence-based prescription guidelines and clinician training in wheeled-mobility technologies.

Key words: assistive technology, cost, DME, durable medical equipment, prosthetic, rehabilitation, scooter, vendor, VISN, wheelchair.

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