Journal of Rehabilitation Research & Development (JRRD)

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Volume 48 Number 2, 2011
   Pages 125 — 134

Abstract —  Medical utilization and cost outcomes for poststroke veterans who receive assistive technology devices from the Veterans Health Administration

Sandra L. Hubbard Winkler, PhD, OTR/L;1-2* Samuel Wu, PhD;1,3 Diane C. Cowper Ripley, PhD;1,3 Shirley Groer, PhD;4 Helen Hoenig, MD5

1Department of Veterans Affairs (VA) Rehabilitation Outcomes Research Center, Research Enhancement Award Program, North Florida/South Georgia Veterans Health System, Gainesville, FL; 2Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL; 3Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, FL; 4James A. Haley Veterans'
Hospital, Tampa, FL; 5Durham VA Medical Center, Durham, NC; and Department of Medicine, Duke University, Durham, NC

Abstract — The study objectives were to (1) advance understanding of the relationship between provision of assistive technology devices (ATDs) and healthcare consumption and outcomes in a system that does not limit provision of ATDs to in-home use and (2) determine how the provision of ATDs relates to inpatient/outpatient utilization and costs of services for veterans 12 months poststroke when controlling for case-mix. This was a retrospective study using Department of Veterans Affairs administrative/workload databases to identify 12,046 veterans with stroke during fiscal years 2001 and 2002. Measures were functional gain, inpatient days, outpatient visits, and inpatient and outpatient costs during the first year poststroke. Motor gain for veterans receiving ATDs was higher than for veterans not receiving ATDs (20 vs 9 Functional Independence Measure points, p < 0.001). Provision of a low-end manual wheelchair was associated with increased inpatient days and costs (both p < 0.001). Provision of a power wheelchair was associated with increased inpatient (p = 0.03) and outpatient costs (p < 0.001). Provision of a scooter was associated with increased outpatient visits and outpatient costs (both p < 0.001). Scooters, walking aids, and power wheelchairs were associated with increased outpatient visits, perhaps functioning as outpatient/community enablers.

Key words: activities of daily living, assistive technology, cost, disability, healthcare utilization, rehabilitation, self-care, stroke, veterans, wheelchair.


View HTML  ¦  View PDF  ¦  Contents Vol. 48, No. 2
This article and any supplementary material should be cited as follows:
Hubbard Winkler SL, Wu S, Cowper Ripley DC, Groer S, Hoenig H. Medical utilization and cost outcomes for poststroke veterans who receive assistive technology devices from the Veterans Health Administration.
J Rehabil Res Dev. 2011;48(2):125-34.
DOI:10.1682/JRRD.2010.05.0081
Crossref

Last Reviewed or Updated  Friday, February 11, 2011 9:51 AM

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