Beauregard Tyler A, Schein Richard M, Berner Theresa F, McKernan Gina, Schmeler Mark R, Dicianno Brad E, DiGiovine Carmen P
School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Disabil Rehabil Assist Technol. 2025 Jul;20(5):1331-1339. doi: 10.1080/17483107.2024.2442705. Epub 2025 Jan 11.
The wheelchair service delivery process (SDP) is a large complex system and therefore has many potential points of failure; determining priorities for improvement is challenging. The complexities introduce several barriers to accessing and maintaining wheelchairs for individuals with mobility impairments. Given the breadth and depth of the barriers, it is important to know in which areas to focus future policy reform efforts.
The purpose is to explore the perceptions of stakeholders regarding the performance of the wheelchair SDP in the United States and guide future policy reforms.
A cross-sectional, observational, online questionnaire was deployed. Questions were positive statements regarding the wheelchair SDP and participants rated their agreement with the statements on a standard six-point Likert scale. A snowball sampling strategy was used and consisted of emailing 42 organisations representing 5 stakeholder groups: (1) consumers/caregivers; (2) clinicians; (3) manufacturers; (4) payers; and (5) suppliers.
1,052 responses were collected: 41% clinicians, 30% suppliers, 24% consumers/caregivers, 3% manufacturers, 2% payers. Stakeholders view the wheelchair SDP as not performing well. Less than 18% of all responses indicate a positive perception. Funding and procurement was viewed in the least positive light, with 5% positive responses. Follow-up, maintenance, and repair was the second least positive component with 9% positive responses. Fitting, training, and delivery was viewed most positively with over 42% positive responses.
The wheelchair SDP is not viewed as performing well by its stakeholders. Funding, procurement, maintenance, and repairs are viewed particularly negatively, representing opportunities for focused system reform efforts.
轮椅服务提供流程（SDP）是一个庞大复杂的系统，因此存在许多潜在的故障点；确定改进的优先事项具有挑战性。这些复杂性给行动不便者获取和维护轮椅带来了若干障碍。鉴于这些障碍的广度和深度，了解未来政策改革应关注哪些领域很重要。
目的是探讨利益相关者对美国轮椅SDP绩效的看法，并指导未来的政策改革。
开展了一项横断面观察性在线问卷调查。问题是关于轮椅SDP的肯定陈述，参与者根据标准的六点李克特量表对这些陈述表示同意的程度进行评分。采用了滚雪球抽样策略，包括向代表5个利益相关者群体的42个组织发送电子邮件：（1）消费者/护理人员；（2）临床医生；（3）制造商；（4）付款人；（5）供应商。
共收集到1052份回复：41%为临床医生，30%为供应商，24%为消费者/护理人员，3%为制造商，2%为付款人。利益相关者认为轮椅SDP表现不佳。所有回复中不到18%表示积极看法。资金和采购方面的看法最不积极，积极回复率为5%。跟进、维护和维修是第二不积极的部分，积极回复率为9%。适配、培训和交付方面的看法最积极，积极回复率超过42%。
利益相关者认为轮椅SDP表现不佳。资金、采购、维护和维修方面的看法尤其负面，这代表了有针对性的系统改革努力的机会。
