Hubbard Sandra L, Fitzgerald Shirley G, Reker Dean M, Boninger Michael L, Cooper Rory A, Kazis Lewis E
Department of Veterans Affairs (VA) Rehabilitation Outcomes Research Center of Excellence, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.
J Rehabil Res Dev. 2006 Nov-Dec;43(7):831-44. doi: 10.1682/jrrd.2005.11.0174.
Little is known about the reasoning process clinicians use when prescribing wheeled mobility equipment (WME) or about the outcomes of this process, i.e., how many devices are prescribed, to whom, how often, and at what cost. This study characterized veterans who received WME from the Veterans Health Administration. We analyzed variance in wheelchair provision based on sex, race/ethnicity, diagnosis, and age. Three years of data from the National Prosthetics Patient Database and the National Patient Care Database were merged, yielding more than 77,000 observations per fiscal year. Logistic regression analysis revealed associations between WME provision and age, sex, and race/ethnicity, when analysis was controlled for diagnosis and number of comorbidities. Hispanics (odds ratio [OR] = 1.864), African Americans (OR = 1.360), and American Indians/Asians (OR = 1.585) were more likely than Caucasians to receive standard wheelchairs. Hispanics (OR = 0.4), African Americans (OR = 0.7), and American Indians/Asians (OR = 0.4) were less likely than Caucasians to receive scooters.
临床医生在开具轮式移动设备(WME)处方时所采用的推理过程,以及该过程的结果,即开具了多少设备、给谁开具、开具频率以及成本如何,目前所知甚少。本研究对从退伍军人健康管理局获得WME的退伍军人进行了特征描述。我们基于性别、种族/民族、诊断和年龄分析了轮椅供应情况的差异。将来自国家假肢患者数据库和国家患者护理数据库的三年数据进行合并,每个财政年度产生了超过77,000条观测数据。在对诊断和合并症数量进行分析控制后,逻辑回归分析揭示了WME供应与年龄、性别和种族/民族之间的关联。西班牙裔(优势比[OR]=1.864)、非裔美国人(OR=1.360)以及美洲印第安人/亚洲人(OR=1.585)比高加索人更有可能获得标准轮椅。西班牙裔(OR=0.4)、非裔美国人(OR=0.7)以及美洲印第安人/亚洲人(OR=0.4)比高加索人获得踏板车的可能性更小。