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动力座椅升高系统的政策分析。

Policy Analysis on Power Seat Elevation Systems.

机构信息

Department of Occupational Therapy, Western Michigan University, Kalamazoo, MI.

Hennepin Healthcare System, Minneapolis, MN.

出版信息

Arch Phys Med Rehabil. 2022 Dec;103(12):2454-2462. doi: 10.1016/j.apmr.2022.04.003. Epub 2022 May 5.

Abstract

In the early 2000s the Centers for Medicare and Medicaid Services determined that power seat elevation systems did not meet the definition of durable medical equipment, and therefore are non-covered items. Yet, power seat elevation systems are covered by other funding sources, and many power wheelchair users utilize these systems regularly when performing tasks such as transferring, reaching, and looking at objects in environments designed for ambulatory people. Adjusting for height when performing these tasks may reduce the onset of pain and comorbidities. To improve access to power seat elevation systems, a clinical team of 4 Clinician Task Force members investigated applicable literature, compiled evidence, and evaluated existing policies to explain the medical nature of power seat elevation systems as a part of a greater interprofessional effort. This manuscript aims to analyze Medicare's policy decision that power seat elevation systems are not primarily medical in nature using Bardach's 8-step framework. As a special communication, this will inform health care professionals of the medical nature of power seat elevation systems and the evidence-based conditions under which power wheelchair users may need power seat elevation systems, as well as empower clinicians to engage in policy directives to affect greater change.

摘要

在 21 世纪初,医疗保险和医疗补助服务中心确定电动座椅提升系统不符合耐用医疗设备的定义,因此不属于保险范围。然而,电动座椅提升系统由其他资金来源覆盖,许多电动轮椅使用者在执行转移、伸手和观察为行动能力人群设计的环境中的物体等任务时经常使用这些系统。在执行这些任务时调整高度可能会减少疼痛和合并症的发生。为了改善电动座椅提升系统的获取,一个由 4 名临床医师任务组成员组成的临床团队调查了适用的文献,汇编了证据,并评估了现有政策,以解释电动座椅提升系统作为更广泛的跨专业努力的一部分的医疗性质。本文旨在使用 Bardach 的 8 步框架分析医疗保险决定电动座椅提升系统主要不是医疗性质的政策。作为一种特殊的交流,这将告知医疗保健专业人员电动座椅提升系统的医疗性质,以及电动轮椅使用者在哪些情况下可能需要电动座椅提升系统的循证条件,并授权临床医生参与政策指令以产生更大的影响。

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