Understanding the Provision of Assistive Mobility and Daily Living Devices and Service Delivery to Veterans After Stroke

Abstract

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.