了解中风后向退伍军人提供辅助移动和日常生活设备及服务的情况。
Understanding the Provision of Assistive Mobility and Daily Living Devices and Service Delivery to Veterans After Stroke.
作者信息
Kairalla John A, Winkler Sandra L, Feng Hua
机构信息
John A. Kairalla, PhD, is Assistant Professor, Department of Biostatistics, University of Florida, Gainesville.
Sandra L. Winkler, PhD, OTR/L, is Research Health Science Specialist, James A. Haley Veterans' Hospital Center of Innovation in Disabilities and Rehabilitation Research, Tampa, FL.
出版信息
Am J Occup Ther. 2016 Jan-Feb;70(1):7001290020p1-7001290020p10. doi: 10.5014/ajot.2016.015768.
OBJECTIVE
The objective of this study was to determine whether facility-level, structural factors affect the provision of assistive devices and services.
DESIGN
A retrospective design was used. Activities of daily living and mobility-related devices were categorized into 11 types. Logistic regression models were performed for each type of device, controlling for patient-level and facility-level covariates.
RESULTS
Non-veteran-level factors significantly affect the provision of assistive devices, even after covariate adjustment. Increased rehabilitation clinician staffing by 1 full-time equivalent position was associated with increased provision odds of 1%-5% for 5 of 11 types of devices. Lower facility complexity was significantly associated with increased provision odds of 35%-59% for 3 types of devices and with decreased provision odds of 16%-69% for 3 types of devices.
CONCLUSION
System-level factors, in addition to patient need, significantly affect the provision of assistive devices. Provision guidelines could assist clinicians in making decisions about device provision.
目的
本研究的目的是确定机构层面的结构因素是否会影响辅助设备及服务的提供。
设计
采用回顾性设计。将日常生活及与移动相关的设备分为11类。针对每种类型的设备进行逻辑回归模型分析，并对患者层面和机构层面的协变量进行控制。
结果
即使在协变量调整之后，非退伍军人层面的因素仍会显著影响辅助设备的提供。康复临床医生人员配备增加1个全职等效岗位，与11种类型设备中的5种设备的提供几率增加1% - 5%相关。机构复杂性较低与3种类型设备的提供几率显著增加35% - 59%以及3种类型设备的提供几率降低16% - 69%相关。
结论
除患者需求外，系统层面的因素也会显著影响辅助设备的提供。提供指南可协助临床医生做出有关设备提供的决策。
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