Article

OBJECTIVES: To assess in Veterans with spinal cord injury (SCI) or amputated limb
(AL) the following: (1) patient demographics, medical factors, cultural and
psychosocial characteristic by race; (2) wheelchair quality by race; and (3) the
independent associations of patient race and the other factors with wheelchair
quality. DESIGN: Cross-sectional cohort study.
SETTING: Three Department of
Veterans Affairs (VA) medical centers affiliated with academic medical centers.
PARTICIPANTS: Eligible participants were Veterans with SCI or ALs (N=516); 482 of
them completed the interview. Analyses were restricted to white and African
American participants. Because there was no variation in wheelchair quality among
AL patients (n=42), they were excluded from all but descriptive analyses, leading
to a final sample size of 421. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURE: Wheelchair quality as defined by the Medicare Healthcare Common
Procedure Coding System. RESULTS: We found race differences in many of our
variables, but not in quality for manual (odds ratio [OR]=.67; 95% confidence
interval [CI], .33-1.36) or power (OR=.82; 95% CI, .51-1.34) wheelchairs. Several
factors including age (OR=.96; 95% CI, .93-.99) and income (OR=3.78; 95% CI,
1.43-9.97) were associated with wheelchair quality. There were no significant
associations of cultural or psychosocial factors with wheelchair quality.
CONCLUSIONS: Although there were no racial differences in wheelchair quality, we
found a significant association of older age and lower income with poorer
wheelchair quality among Veterans. Efforts are needed to raise awareness of such
disparities among VA wheelchair providers and to take steps to eliminate these
disparities in prescription practice across VA sites.
CI - Published by Elsevier Inc.

Langue : ANGLAIS