Category: Health Policy and Systems
This study characterizes the demographics and durable medical equipment (DME) needs of uninsured and underinsured persons with disabilities at a philanthropic rehabilitation clinic as a first step to improve utilization and management of the limited clinic resources.
All individuals who presented to the clinic between 2013 and 2018 requesting DME were included in the study; those whose paper charts were incomplete/illegible were excluded. Data collected from chart review included sex, age, ethnicity, insurance status, diagnoses, and DME requested/received.
There was a total of 1,157 encounters for DME requests from the clinic, 52.4% of individuals were uninsured, 16.1% Medicare, 8.8% Medicaid, 8.5% both Medicare and Medicaid, 6.7% private insurance. In addition, 55.0% of the requests were from Hispanic patients, while 28.3% and 13.6% were from African American and Caucasian patients, respectively.
Individuals carried a diagnosis of: 21.9% Spinal Cord Injury, 16.9% Musculoskeletal Disorders, 13.6% Stroke, 7.6% Autoimmune/Inflammatory Disorders, 7.3% Congenital Disorders, 5.2% Amputation, 4.1% Traumatic Brain Injury, and 3.9% Malignancy.
A total of 2,680 items were distributed: 34.5% were Wheelchair Parts & Repair, 30.1% Personal Hygiene/Incontinence Supplies, 25.0% Mobility Equipment, and 10.6% Bathroom Equipment.
11.1% of the requests could not be fulfilled. Of the items requested, 44.2% were Mobility Equipment, 21.3% Wheelchair Parts & Repair, 15.1% Personal Hygiene/Incontinence Supplies, and 9.7% Bathroom Equipment.
More than a quarter of the DME requests were from individuals with either private insurance or federal payers, which implies lack of adequate coverage on DME to maintain patients’ mobility and independence.
This analysis will aid in the clinic’s future endeavors, such as identifying and purchasing most needed DME and guiding new organizations with similar aims.
Claudia Martinez– Medical Student, McGovern Medical School at UTHealth in Houston
Ashley Sanchez– Medical Student, McGovern Medical School at UTHealth in Houston
Jean Woo– Brain Injury Fellow, Baylor College of Medicine
Monica Verduzco-Gutierrez– VC & Associate Professor; Medical Director, Brain Injury and Stroke Program, McGovern Medical School at UTHealth at Houston