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Citation
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Myaskovsky L, Gao S, Hausmann LR, Bornemann KR, Burkitt KH, Switzer GE, Fine MJ, Phillips SL, Gater D, Spungen AM, Worobey L, Boninger ML. Arch. Phys. Med. Rehabil. 2016; 98(3): 442-449. |
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Affiliation
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Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA; Center for Wheelchairs and Associated Rehabilitation Engineering, VA Pittsburgh Healthcare System, Pittsburgh, PA. |
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Abstract
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OBJECTIVE: In this study of Veterans with spinal cord injury (SCI) or amputated limb (AL), our objectives were to (a) compare patient demographics, medical factors, cultural and psychosocial characteristic by race; (b) compare wheelchair quality by race; and, (c) assess the independent associations of patient race and the other factors with wheelchair quality.
DESIGN: Cross sectional cohort study SETTING: Three VA Medical Centers affiliated with academic medical centers. PARTICIPANTS: Of 516 eligible participants, 482 completed the interview. Analyses were restricted to white (WH) and African American (AA) participants. Because there was no variation in wheelchair quality among AL patients (n=42), they were excluded from all but descriptive analyses leading to a final sample size of 421. INTERVENTION: NA MAIN OUTCOME MEASURE: Wheelchair quality as defined by the Medicare Healthcare Common Procedure Coding System RESULTS: We found race differences in many of our variables, but not in quality for manual (OR=0.67, 95% CI: 0.33-1.36) or power (OR=0.82, 95% CI: 0.51-1.34) wheelchairs. Several factors, including age (OR=0.96, 95% CI: 0.93-0.99) and income (OR=3.78, 95% CI: 1.43-9.97) were associated with wheelchair quality. There were no significant associations of cultural or psychosocial factors with wheelchair quality.
CONCLUSIONS: Although there were no racial differences in wheelchair quality, we found a significant association of older age and lower income with poorer wheelchair quality among Veterans. Efforts are needed to raise awareness of such disparities among VA wheelchair providers and to take steps to eliminate these disparities in prescription practice across VA sites.
Copyright © 2016. Published by Elsevier Inc.
Language: en |