Document Detail

Wheeled mobility (wheelchair) service delivery: scope of the evidence.
MedLine Citation:
PMID:  22250145     Owner:  NLM     Status:  MEDLINE    
Identifying the appropriate wheelchair for a person who needs one has implications for both disabled persons and society. For someone with severe locomotive problems, the right wheelchair can affect mobility and quality of life. However, policymakers are concerned about the increasing demand for unnecessarily elaborate chairs. The Office of Inspector General, U.S. Department of Health and Human Services, issued 4 reports between 2009 and 2011 detailing fraud and misapplication of Medicare funds for powered wheelchairs, more than a decade after similar concerns were first raised by 4 contractors who process claims for durable medical equipment. Subsequent concerns have arisen about whether some impaired persons who need wheeled mobility devices may now be inappropriately denied coverage. A transparent, evidence-based approach to wheeled mobility service delivery (the matching of mobility-impaired persons to appropriate devices and supporting services) might lessen these concerns. This review describes the process of wheeled mobility service delivery for long-term wheelchair users with complex rehabilitation needs and presents findings from a survey of the literature (published and gray) and interviews with key informants. Recommended steps in the delivery process were identified in textbooks, guidelines, and published literature. Delivery processes shared many commonalities; however, no research supports the recommended approaches. A search of bibliographic databases through March 2011 identified 24 studies that evaluated aspects of wheeled mobility service delivery. Most were observational, exploratory studies designed to determine consumer use of and satisfaction with the process. The evidence base for the effectiveness of approaches to wheeled mobility service delivery is insufficient, and additional research is needed to develop standards and guidelines.
Nancy Greer; Michelle Brasure; Timothy J Wilt
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Annals of internal medicine     Volume:  156     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-17     Completed Date:  2012-07-03     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  141-6     Citation Subset:  AIM; IM    
Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minnesota, USA.
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MeSH Terms
Activities of Daily Living
Costs and Cost Analysis
Delivery of Health Care / standards*
Disabled Persons / rehabilitation*
Equipment Design
Health Services Research
Medicare / economics
United States
Wheelchairs* / economics
Grant Support
290-07-10064-I//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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