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Reusing AT/DME Acquired Through Public Funds: Developing a Cost-Neutral, Consumer Driven Model

Thursday, July 8, 2004

Staff from the Assistive Technology for Kansans project received a grant from the National Institute on Disability and Rehabilitation Research (NIDRR) to develop a Durable Medical Equipment (DME) reuse program.

The original proposal had two primary components: (1) planning and implementing a model equipment reuse program, and (2) collecting and analyzing data regarding the outcomes of acquiring DME and its impact on persons’ lives.

To address the first component, the project staff worked closely with Kansas Medical Policy (Medicaid), DME providers, and consumers to plan and implement a model equipment reuse program. During the second year of the NIDRR grant, Kansas Medical Policy awarded a contract to the University of Kansas to operate the program, called the Kansas Equipment Exchange, throughout the state. (For more information about the Kansas Equipment Exchange, see the May, 2003 issue of The Insider.) Thus, the primary focus for the remainder of the federal grant period is the collection and analyses of consumer data.

Data collection consists primarily of in-depth telephone interviews with persons who receive Medicaid-funded equipment such as manual or powered wheelchairs, augmentative communication devices, and hospital-type beds. Preliminary results based on almost 200 interviews have generated a number of interesting findings, which are being shared through presentations at a number of state and national conference presentations. Some of these findings are as follows:

Among children who received wheelchairs, 87% reported an impact on others in their lives (less need for assistance, family members worry less), 86.4% reported that their chair allowed them to feel more comfortable, 65% improved their ability to participate in recreation, leisure, community, or social activities, and 65% improved their ability to participate in learning and/or educational activities. Among children who received communication devices, 92.9% improved their ability to participate in learning and/or educational activities, 78.6% improved their ability to communicate with family and friends, and 57.1% reported an impact on others in their lives (less frustration, better interactions). Among adults who received wheelchairs, 87.8% reported that their chair allowed them to feel more comfortable, 83.3% reported an impact on others in their lives (less need for assistance, family members worry less), 75% reported that their chair made them feel safer, and 67.4% improved their ability to participate in recreation, leisure, community, or social activities.

Among adults who received communication devices, 83.3% improved their ability to communicate with family and friends, 75% reported an impact on others in their lives (less frustration, better interactions), 70% improved their ability to participate in learning and/or educational activities, and 60% improved their ability to participate in recreation, leisure, community, or social activities.

Another interesting finding is that significant differences (p <.05) have been found between people with mobility limitations (that is, people who use wheelchairs or other mobility aids) who acquired a communication device and people without mobility limitations who acquired a communication device. These differences occurred in the following areas:

  • Persons with mobility limitations reported at a significantly higher rate that their communication device was extremely important to them.
  • Persons with mobility limitations reported at a significantly higher rate that their ability to do home/community living management activities (such as shopping, cooking, and cleaning) improved after they received their communication device.
  • Persons with mobility limitations reported at a significantly higher rate that their ability to participate in recreation, leisure, community or social activities improved after they received their communication device.
  • Persons with mobility limitations reported at a significantly higher rate that their ability to participate in important life roles (such as parent, spouse, or friend) improved after they received their communication device.

The information gathered through the surveys is also being used to develop recommendations for policy makers and practitioners. At the close of the project a CD-ROM replication guide, including the database software and materials created, as well as an analysis of data collected, will be available to other entities that wish to replicate the program.



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