Associations Between Insurance Provider and Assistive Technology Use for Computer and Electronic Devices 1 Year After Tetraplegia: Findings From the Spinal Cord Injury Model Systems National Database

Kimberley R. Monden, Mitch Sevigny, Jessica M. Ketchum, Susan Charlifue, Ellen Severe, Candy Tefertiller, Jeff Berliner, Jennifer Coker, Heather B. Taylor, Stephanie A. Kolakowsky-Hayner, Leslie R. Morse

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate the association between insurance provider and reported assistive technology (AT) use to access computers and electronic devices 1 year after sustaining tetraplegia. Design: Multicenter cross-sectional study. Setting: Participants enrolled in the Spinal Cord Injury Model Systems (SCIMS) National Database. Interventions: Not applicable. Participants: Men and women with tetraplegia (N=498) enrolled in the SCIMS National Database were included in the analysis. Main Outcome Measures: The primary study outcome was the use of AT when operating a computer or other mobile electronic device. The primary predictor was the subject's principal health insurance provider, which was grouped into the 3 categories: government (Medicare, Medicaid, and other government), private (private insurance, private funds, and other), and workers’ compensation. Results: Overall, 34.7% of participants reported using AT to access computers and electronic devices. Results of logistic regression analysis revealed sex, injury level, injury completeness, self-perceived health status, and 12-month history of pressure ulcer were all significantly associated with AT use. After adjusting for these factors, participants with workers’ compensation were more likely to report AT use than individuals with either government or private insurance. Conclusions: Despite significant technological advances, AT is not readily available to the people who might benefit most from its use. Findings from the present study are the first to shed light on AT funding sources and reveal that individuals with workers’ compensation are more likely use AT than individuals with either government or private insurance. Additional work focused on AT use and functional outcomes is needed to assess the effect of barriers to use. Collectively, this work may inform insurers of the importance of having AT available for this unique population to potentially improve quality of life and participation.

Original languageEnglish (US)
Pages (from-to)2260-2266
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume100
Issue number12
DOIs
StatePublished - Dec 2019

Bibliographical note

Funding Information:
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR 90SI5007, 90SI5015-01-00, 90SI5017, 90SI5027) and the Office of the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense through the Spinal Cord Injury Research Program Qualitative Research Award (award no. W81XWH-18-1-0806). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21702-5014, is the awarding and administering acquisition office. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense.

Publisher Copyright:
© 2019 American Congress of Rehabilitation Medicine

Keywords

  • Insurance
  • Rehabilitation
  • Self-help devices
  • Spinal cord injuries

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