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Retrospective Chart Review Examining Differences and Timelines in Recommended and Delivered Wheelchair Equipment in a
Cara E Masselink1, Linda Shuster2, Kerri A Morgan3
1Department of Occupational Therapy, Western Michigan University, Kalamazoo, MI.
Objective:
To compare recommended wheeled mobility equipment with delivered equipment, excluding custom seats and backs, considering demographic factors, such as sex, age, and funding source, as well as the timeline of the procurement process.
Design:
Retrospective chart review.
Setting:
Dedicated wheelchair seating department within a Midwestern rehabilitation hospital and associated complex rehabilitation technology durable medical equipment suppliers.
Participants:
Wheelchair recommendations (N=546) made between January 1, 2017, and December 31, 2017, to physician-referred wheelchair users of all ages and diagnoses.
Interventions:
Not applicable.
Main Outcome Measures:
Recommended and delivered wheelchair equipment type and length of time between recommendation and delivery.
Results:
Differences were found between the recommended and delivered equipment in manual wheelchairs, power mobility devices, seat backs, cushions, and power option equipment groups (P≤.001). Delivered manual wheelchairs were 7% more likely to be different than the recommendation for each year decrease in age (P≤.001), although the model lacked sufficient predictive accuracy for clinical application. The average length of time from equipment recommendation to delivery was about 6 months (mean, 176d). Standard and complex power mobility devices were associated with longer timelines (median, 137d and 173d, respectively; P=.001), although only complex power mobility device timelines were significantly associated with public funding sources (P=.02).
Conclusions:
Wheelchair bases, positioning accessories, and power options may be delivered differently than originally recommended, and the process for procuring complex power mobility devices with public funding sources should be studied further. Health care professionals should consistently follow up on delivered equipment to ensure that expectations and needs of the wheelchair user are met. Reducing systemic barriers to interdisciplinary communication postrecommendation may improve patient outcomes.
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