Medical Utilization and Cost Outcomes for Poststroke Veterans Who Receive Assistive Technology Devices From the Veterans Health AdministrationBy Winkler, Sandra L. Hubbard; Wu, Samuel; Ripley, Diane C. Cowper; Groer, Shirley; Hoenig, Helen; Journal of Rehabilitation Research and Development, Vol. 48, No. 2, pp. 125-134
Publication Date: 2011
Study undertaken 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 and outpatient utilization and costs of services for veterans 12 months poststroke when controlling for case-mix. The retrospective study used 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 was 20 Functional Independence Measure (FIM) points for veterans receiving ATDs compared to 9 FIM points for those not receiving ATDs. Provision of a low end manual wheelchair was associated with increased inpatient days and costs, while provision of a power wheelchair was associated with increased inpatient and outpatient costs, and provision of a scooter was associated with increased outpatient visits and costs. Scooters, walking aids including walkers, crutches, and canes, and power wheelchairs were linked to increased outpatient visits, possibly functioning as outpatient/community enablers. Based on study findings, the authors conclude that provision of mobility ATDs to veterans predicts greater functional gain while in the hospital and greater numbers of outpatient visits when both disability and comorbidity were controlled for. Study limitations and implications for further research are discussed.
VA Rehabilitation Research & Development Service (Web Site: http://www.rehab.research.va.gov )
Link to text: http://www.rehab.research.va.gov/jour/11/482/winkler.html