Research Article
Issue Date: December 18, 2015
Published Online: December 21, 2015
Updated: June 13, 2018
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 18, 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, 7001290020. https://doi.org/10.5014/ajot.2016.015768
American Journal of Occupational Therapy, December 2015, Vol. 70, 7001290020. https://doi.org/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.