Effectiveness of the VA System of Providing Prosthetic Devices to Meet Veterans Needs

Principal Investigator/s: Shirley Fitzgerald, PhD

5/2002 – 4/2003

The purpose of the database research project titled "Effectiveness of the VA System of Providing Prosthetic Devices to Meet Veterans Needs" is to determine: (1) variance in the provision of wheelchairs and scooters by the VHAaccording to demographic characteristics, geographic location (VISN), and cost, and (2) the relationship between quality of wheelchair provided and health related qualityof life. Using a retrospective study design, three years of data from three VHAdatabases (the National Patient Prosthetics Database, the National Patient Care Database, and the SF-36V of the Veterans Health Study), were merged to characterize veterans who received wheelchairs and scooters from the VHA during FY99, FY00, and FY01. The questions and hypotheses are as follows. Research Question 1a: How many veterans received initial issue, spare, and replacement wheelchairs by the VHA? 1b: What are the demographic characteristics of these veterans? 1c: What are the most frequent diagnoses of these veterans? Hypothesis 1: The type of wheelchair provided to veterans will differ significantly according to age, gender, race/ethnicity, and diagnosis. Hypothesis 2: The proportion of light-weight and ultra-light manual wheelchairs to standard wheelchairs will be significantly higher in urban areas than in rural areas, as defined by the zip code of the prescribing facility. Hypothesis 3: The type of wheelchair provided will vary significantly between VISNs. Hypothesis 4: The mean cost of a wheelchair or scooter will vary significantly between VISNS. Hypothesis 5: Within a VISN, the mean cost of a wheelchair or scooter will vary significantly between vendors. Hypothesis 6: The mean expenditure over a 2-year period for wheelchairs per veteran will vary significantly by diagnosis. Hypothesis 7: Individuals who are provided with better quality, more custom wheelchairs will have significantly more ability to participate in society than individuals who have been provided with lower quality, non-custom wheelchairs. Hypothesis 8: Individuals who are provided with better quality, more custom wheelchairs will demonstrate significantly more disability than individuals who have been provided with lower quality, non-custom wheelchairs. Descriptive statistics, t-test, ANOVA, and logistic regression are being used for analyzes. The results of this study will provide information on patterns of provision of wheeled mobility devices for policy makers and clinicians, so they may more equitably provide wheeled mobility devices to veterans, as well as realize the relationship between device and quality of life.