Research Article  |   December 2015
Understanding the Provision of Assistive Mobility and Daily Living Devices and Service Delivery to Veterans After Stroke
Author Affiliations
  • 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
  • Hua Feng, MS, is Senior Biostatistician, Veterans Affairs (VA) Health Services Research & Development Center of Innovation, Michael E. DeBakey VA Medical Center, Houston, TX, and Senior Biostatistician, Department of Medicine, Baylor College of Medicine, Houston, TX
Article Information
Assistive Technology / Military Rehabilitation / Neurologic Conditions / Rehabilitation, Participation, and Disability / Stroke / Rehabilitation, Disability, and Participation
Research Article   |   December 2015
Understanding the Provision of Assistive Mobility and Daily Living Devices and Service Delivery to Veterans After Stroke
American Journal of Occupational Therapy, December 2015, Vol. 70, 7001290020p1-7001290020p10. doi:10.5014/ajot.2016.015768
American Journal of Occupational Therapy, December 2015, Vol. 70, 7001290020p1-7001290020p10. doi:10.5014/ajot.2016.015768
Abstract

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.